Nayyar Rishi, Singh Prabhjot, Gupta Narmada P, Hemal Ashok K, Dogra Prem N, Seth Amlesh, Kumar Rajeev
Department of Urology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029, India.
Indian J Urol. 2010 Jan-Mar;26(1):56-9. doi: 10.4103/0970-1591.60445.
To assess the accuracy of Gleason grading/scoring on preoperative needle core biopsy (NCB) compared to the radical prostatectomy (RP) specimen.
Data of NCB and RP specimens was analyzed in 193 cases. Gleason grade/scoring was done on both NCB and RP specimens. Sixteen cases were excluded for various reasons. The Gleason scores of the two sets of matched specimens were compared and also correlated with the PSA, age, and number of needle biopsy cores. The overall change was also correlated with the initial score on NCB.
The mean age and PSA were 63.3+/-2(5.27) years and 18.48+/-2(28.42) ng/ml, respectively. The average Gleason score increased from 5.51 +/- 2(1.52) to 6.2 +/- 2(1.42) (P<0.02). The primary grade increased in 57 (32.2%) cases. Overall, 97 (54.8%) cases had an increase in Gleason score. Five other cases had a change from 3 + 4 = 7 to 4 + 3 = 7. Change in Gleason score was significantly more if the score on NCB was </=6 or number of needle cores was </=6. Besides, 28 cases had perineural invasion, 16 had capsular invasion (pT3(a)), and 4 had vascular invasion on RP specimen.
There is a significant upgrading of Gleason score on RP specimens when compared with NCB. This trend may be correlated positively with lower initial Gleason score on preoperative biopsy and the lower number of cores taken.
评估术前穿刺活检（NCB）与根治性前列腺切除术（RP）标本相比时Gleason分级/评分的准确性。
分析193例患者的NCB和RP标本数据。对NCB和RP标本均进行Gleason分级/评分。16例因各种原因被排除。比较两组匹配标本的Gleason评分，并与前列腺特异性抗原（PSA）、年龄和穿刺活检针数相关联。总体变化也与NCB的初始评分相关。
平均年龄和PSA分别为63.3±2（5.27）岁和18.48±2（28.42）ng/ml。平均Gleason评分从5.51±2（1.52）增加到6.2±2（1.42）（P<0.02）。57例（32.2%）主要分级增加。总体而言，97例（54.8%）Gleason评分增加。另外5例从3+4=7变为4+3=7。如果NCB评分≤6或穿刺针数≤6，Gleason评分变化显著更大。此外，28例在RP标本上有神经周围侵犯，16例有包膜侵犯（pT3(a)），4例有血管侵犯。
与NCB相比，RP标本的Gleason评分有显著上调。这种趋势可能与术前活检时较低的初始Gleason评分和较少的穿刺针数呈正相关。
