Alchin David R, Murphy Declan, Lawrentschuk Nathan
Peter MacCallum Cancer Centre, Department of Surgical Oncology, University of Melbourne, Melbourne, Australia -
Peter MacCallum Cancer Centre, Department of Surgical Oncology, University of Melbourne, Melbourne, Australia.
Minerva Urol Nefrol. 2017 Oct;69(5):459-465. doi: 10.23736/S0393-2249.16.02684-9. Epub 2016 Dec 22.
Gleason Score discordance can confound optimal treatment allocation of patients diagnosed with prostate cancer and place these patients at risk of worse oncological outcomes. Its prevalence remains endemic; its exact causation remains unknown. The objective of this review was to examine the observational studies of patient cohorts who have undergone radical prostatectomy with the aim of identifying any preoperative variables that may be associated with an upgrade in final prostatectomy Gleason Score.
A non-systematic review of English articles from 2010 to present was performed through a MEDLINE search. Search terms included "Gleason Score," "pathological," "upgrade," and "radical prostatectomy."
All studies included for review were retrospective analyses of radical prostatectomy series that examined factors associated with Gleason Score discordance.
The various studies found that Gleason Score upgrading remains highly prevalent, and that some association can be seen with greater percent positive cores, longer biopsy core lengths, smaller prostate glands, higher percent tumor volume per gland, prostate-specific antigen density and visible lesions on multiparametric magnetic resonance imaging.
Gleason评分不一致可能会混淆前列腺癌患者的最佳治疗分配，并使这些患者面临更差肿瘤学结局的风险。其患病率仍然很高；其确切病因尚不清楚。本综述的目的是检查接受根治性前列腺切除术的患者队列的观察性研究，以确定任何可能与最终前列腺切除Gleason评分升级相关的术前变量。
通过MEDLINE搜索对2010年至今的英文文章进行了非系统性综述。搜索词包括“Gleason评分”、“病理”、“升级”和“根治性前列腺切除术”。
纳入综述的所有研究均为根治性前列腺切除术系列的回顾性分析，研究了与Gleason评分不一致相关的因素。
各项研究发现，Gleason评分升级仍然非常普遍，并且可以看到与更高的阳性核心百分比、更长的活检核心长度、更小的前列腺、每个腺体更高的肿瘤体积百分比、前列腺特异性抗原密度以及多参数磁共振成像上的可见病变之间存在一些关联。
