Bright Elizabeth, Manuel Clare, Goddard Jonathan C, Khan Masood A
Department of Urology, University Hospitals of Leicester NHS Trust, Leicester General Hospital, Leicester, UK.
Urol Int. 2010;84(2):180-4. doi: 10.1159/000277595. Epub 2010 Mar 4.
To determine whether Gleason score up-grading is still occurring in men diagnosed with adenocarcinoma of the prostate via extended biopsy regimens, and factors that might predict this.
Between September 1999 and February 2007, 211 men (age: 42-70 years; mean: 60 years) underwent trans-rectal ultrasound-guided prostate biopsies confirming clinically localized adenocarcinoma followed by radical prostatectomy (RP), within our department. Univariate and multivariate logistic regression (LR) analyses using age, serum PSA, prostate volume, clinical stage and total length of cores taken were performed to determine whether Gleason score up-grading could be predicted.
A total of 7/20 (35%), 24/64 (38%) and 36/127 (28%) men with 6, 7-9 and at least 10 core biopsies experienced Gleason score up-grading (p = nonsignificant between the 3 groups). Both univariate and multivariate LR analyses failed to determine any of our variables as a predictor of Gleason score up-grading from biopsy to RP.
Despite increasing the number of cores taken at biopsy, in order to improve prostate cancer diagnosis, a substantial percentage of men still experience Gleason score up-grading from biopsy to RP. In addition, we were unable to determine any predicting factors for this up-grading.
确定通过扩展活检方案诊断为前列腺腺癌的男性患者中是否仍会出现Gleason评分升级，以及可能预测这种情况的因素。
1999年9月至2007年2月期间，211名男性（年龄42 - 70岁；平均60岁）在我科接受经直肠超声引导下前列腺活检，确诊为临床局限性腺癌，随后接受根治性前列腺切除术（RP）。采用年龄、血清前列腺特异性抗原（PSA）、前列腺体积、临床分期和所取活检组织总长度进行单因素和多因素逻辑回归（LR）分析，以确定是否可以预测Gleason评分升级。
分别进行了6针、7 - 9针和至少10针活检的男性患者中，出现Gleason评分升级的比例分别为7/20（35%）、24/64（38%）和36/127（28%）（三组之间p值无统计学意义）。单因素和多因素LR分析均未能确定我们所研究的任何变量可作为从活检到RP过程中Gleason评分升级的预测指标。
尽管增加了活检针数以改善前列腺癌诊断，但仍有相当比例的男性患者从活检到RP过程中出现Gleason评分升级。此外，我们无法确定这种升级的任何预测因素。
