Department of Pathology, University Hospital of Wales, Cardiff, UK.
Department of Urology, University Hospital of Wales, Cardiff, UK.
J Clin Pathol. 2018 Oct;71(10):874-878. doi: 10.1136/jclinpath-2018-205093. Epub 2018 May 2.
To determine how clinicians use data in contemporary prostate biopsy reports.
A survey was circulated to members of the British Association of Urological Surgeons and the British Uro-oncology Group.
Responses were received from 114 respondents (88 urologists, 26 oncologists). Ninety-seven (94%) use the number of positive cores from each side and 43 (42%) use the % number of positive cores. When determining the number and percentage of positive cores, 72 (71%) would not differentiate between targeted and non-targeted samples. If multiple Gleason Scores (GS) were included in a report, 77 (78%) would use the worst GS even if present in a core with very little tumour, 12% would use the global GS and 10% the GS in the core most involved by tumour. Fifty-five (55%) either never or rarely used perineural invasion for patient management.
The number of positive cores is an important parameter for patient management but may be difficult to determine in the laboratory due to core fragmentation so the biopsy taker must indicate the number of biopsies obtained. Multiple biopsies taken from a single site are often interpreted by clinicians as separate cores when determining the number of positive cores so pathologists should also report the number of positive. Clinicians have a non-uniform approach to the interpretation of multiple GS in prostate biopsy reports so we recommend that pathologists also include a single 'bottom-line' GS for each case to direct the clinician's treatment decision.
确定临床医生如何在当代前列腺活检报告中使用数据。
向英国泌尿外科医师协会和英国泌尿肿瘤学组的成员分发了一份调查。
收到了 114 名受访者（88 名泌尿科医生，26 名肿瘤学家）的回复。97 名（94%）使用来自每一侧的阳性核心数量，43 名（42%）使用阳性核心的%数量。在确定阳性核心的数量和百分比时，72 名（71%）不会区分靶向和非靶向样本。如果报告中包含多个 Gleason 评分（GS），77 名（78%）即使在肿瘤很少的核心中也会使用最差 GS，12%会使用全球 GS，10%会使用肿瘤累及最多的核心中的 GS。55 名（55%）要么从不，要么很少将神经周围侵犯用于患者管理。
阳性核心的数量是患者管理的一个重要参数，但由于核心碎片化，在实验室中可能难以确定，因此活检采集者必须指出获得的活检数量。从单个部位采集的多个活检在确定阳性核心数量时通常被临床医生视为单独的核心，因此病理学家也应报告阳性核心的数量。临床医生对前列腺活检报告中多个 GS 的解释方法不一致，因此我们建议病理学家也应为每个病例提供单个“底线”GS，以指导临床医生的治疗决策。
