Ozok Hakki Ugur, Sagnak Levent, Tuygun Can, Oktay Murat, Karakoyunlu Nihat, Ersoy Hamit, Alper Murat
Diskapi Yildirim Beyazit Training and Research Hospital, Department of 3rd Urology, Ministry of Health, Ankara, Turkey.
Int J Surg Pathol. 2010 Aug;18(4):248-54. doi: 10.1177/1066896909346272. Epub 2009 Sep 30.
The aim of the present study was to determine how the modified Gleason grading (mGG) system affects the score discrepancy between needle biopsy (NB) and radical prostatectomy (RP) and to investigate the effect of the modified scores on nomogram predictions. When the conventional Gleason grading (cGG) and mGG systems were compared, a new Gleason score was obtained in the NBs for 40 out of 97 patients (41.2%; P < .001) and in the RP specimens for 15 out of 97 patients (15.5%; P = .005). The agreement between the NBs and RP specimens rose from 31.9% to 44.3% with the mGG system (P = .017). However, when the predictions calculated with the location of modified Gleason scores in the Memorial Sloan Kettering Cancer Center nomogram were compared with those of the conventional Gleason scores, higher pathological stage and lower life expectancy predictions were obtained. Therefore, when a clinician is making a choice from therapeutic options, this change should be taken into account.
本研究的目的是确定改良的Gleason分级（mGG）系统如何影响穿刺活检（NB）与根治性前列腺切除术（RP）之间的评分差异，并研究改良评分对列线图预测的影响。当比较传统的Gleason分级（cGG）和mGG系统时，97例患者中有40例（41.2%；P <.001）的NB获得了新的Gleason评分，97例患者中有15例（15.5%；P =.005）的RP标本获得了新的Gleason评分。使用mGG系统时，NB与RP标本之间的一致性从31.9%提高到了44.3%（P =.017）。然而，当将纪念斯隆凯特琳癌症中心列线图中根据改良Gleason评分位置计算的预测结果与传统Gleason评分的预测结果进行比较时，得到了更高的病理分期和更低的预期寿命预测。因此，当临床医生在治疗方案中进行选择时，应考虑到这一变化。
