Soga Norihito, Yatabe Yasushi, Kageyama Takumi, Ogura Yuji, Hayashi Norio
Department of Urology, Aichi Cancer Center Hospital, Nagoya, Japan.
Urol Int. 2015;95(4):452-6. doi: 10.1159/000439440. Epub 2015 Oct 3.
The Gleason score (GS) is the primary classification of clinical risk in prostate cancer (PCa). Here, we estimated the factors predictive of accordance of local and central pathologist-dependent GS and clinical risk classification in an increased number of cases.
Between January 2009 and December 2013, 388 patients were diagnosed with PCa by 80 independent pathologists from local communities and were referred to our hospital. Validation of the GS with needle-core biopsy specimens was carried out by a single central pathologist, and clinical risk, according to the D'Amico risk classification, was determined. Discrepancies between the GS and risk classification, based on the GS estimated by the local or central pathologist, were reviewed, and predictive factors for accordance of clinical risk classification were estimated.
When pathological results were compared, 59.5% of cases were given concordant GSs by local and central pathologists. A significant discrepancy existed in the classification of intermediate risk (p < 0.0001). Multivariate analysis indicated that local pathologist-dependent GS7, lower prostate-specific antigen (≤ 10 ng/ml), and lower T stage (T1 or T2a) were significant predictive factors for discordance with the central pathologist-dependent risk classification.
Review of bioptic GSs by central pathologists affected discrepancies in risk classification in patients with PCa.
Gleason评分（GS）是前列腺癌（PCa）临床风险的主要分类。在此，我们在更多病例中估计了预测局部和中心病理学家依赖的GS与临床风险分类一致性的因素。
2009年1月至2013年12月期间，80名来自当地社区的独立病理学家诊断出388例PCa患者，并将其转诊至我院。由一名中心病理学家对针芯活检标本的GS进行验证，并根据D'Amico风险分类确定临床风险。审查基于局部或中心病理学家估计的GS的GS与风险分类之间的差异，并估计临床风险分类一致性的预测因素。
比较病理结果时，59.5%的病例局部和中心病理学家给出的GS一致。中危分类存在显著差异（p<0.0001）。多变量分析表明，局部病理学家依赖的GS7、较低的前列腺特异性抗原（≤10 ng/ml）和较低的T分期（T1或T2a）是与中心病理学家依赖的风险分类不一致的显著预测因素。
中心病理学家对活检GS的审查影响了PCa患者风险分类的差异。
