Samaratunga Hemamali, Delahunt Brett, Gianduzzo Troy, Coughlin Geoff, Duffy David, LeFevre Ian, Johannsen Shulammite, Egevad Lars, Yaxley John
1Aquesta Pathology 2University of Queensland 3Wesley Hospital, Brisbane, Qld, Australia 4Wellington School of Medicine and Health Sciences, University of Otago, Department of Pathology and Molecular Medicine, Wellington, Otago, New Zealand 5Department of Oncology-Pathology, Karolinska Institute, Stockholm, Sweden.
Pathology. 2015 Oct;47(6):515-9. doi: 10.1097/PAT.0000000000000315.
The 2005 International Society of Urological Pathology (ISUP) modified Gleason grading system was further amended in 2014 with the establishment of grade groupings (ISUP grading). This study examined the predictive value of ISUP grading, comparing results with recognised prognostic parameters.Of 3700 men undergoing radical prostatectomy (RP) reported at Aquesta Pathology between 2008 and 2013, 2079 also had a positive needle biopsy available for review. We examined the association between needle biopsy 2014 ISUP grade and 2005 modified Gleason score, tumour volume, pathological stage of the subsequent RP tumour, as well as biochemical recurrence-free survival (BRFS). The median age was 62 (range 32-79 years). Median serum prostate specific antigen was 5.9 (range 0.4-69 ng/mL). For needle biopsies, 280 (13.5%), 1031 (49.6%), 366 (17.6%), 77 (3.7%) and 325 (15.6%) were 2014 ISUP grades 1-5, respectively. Needle biopsy 2014 ISUP grade showed a significant association with RP tumour volume (p < 0.001), TNM pT and N stage (p < 0.001) and BRFS (p < 0.001). Multivariate analysis using Cox proportional hazards regression model showed serum prostate specific antigen (PSA) at the time of diagnosis and ISUP grade >2 to be significantly associated with BRFS.This study provides evidence of the prognostic significance of ISUP grading for thin core needle biopsy of prostate.
2005年国际泌尿病理学会（ISUP）修订的Gleason分级系统于2014年随着分级分组（ISUP分级）的建立而进一步修订。本研究检验了ISUP分级的预测价值，并将结果与公认的预后参数进行比较。在阿夸斯塔病理学报告的2008年至2013年间接受根治性前列腺切除术（RP）的3700名男性中，2079名患者也有阳性穿刺活检结果可供复查。我们研究了穿刺活检2014年ISUP分级与2005年修订的Gleason评分、肿瘤体积、后续RP肿瘤的病理分期以及无生化复发生存期（BRFS）之间的关联。中位年龄为62岁（范围32 - 79岁）。中位血清前列腺特异性抗原为5.9（范围0.4 - 69 ng/mL）。对于穿刺活检，2014年ISUP 1 - 5级分别为280例（13.5%）、1031例（49.6%）、366例（17.6%）、77例（3.7%）和325例（15.6%）。穿刺活检2014年ISUP分级与RP肿瘤体积（p < 0.001）、TNM pT和N分期（p < 0.001）以及BRFS（p < 0.001）显著相关。使用Cox比例风险回归模型进行的多因素分析显示，诊断时的血清前列腺特异性抗原（PSA）和ISUP分级>2与BRFS显著相关。本研究提供了证据，证明ISUP分级对前列腺细针穿刺活检具有预后意义。
