Yeldir Neşe, Yildiz Esin, Dündar Gökçe
Department of Pathology, Cizre Dr. Selahattin Cizrelioğlu State Hospital, ŞIRNAK, TURKEY.
Turk Patoloji Derg. 2019;35(3):185-192. doi: 10.5146/tjpath.2018.01453.
Prostate cancer is the second most common cancer in men. Digital rectal examination, transrectal ultrasonography and serum prostate specific antigen represents a diagnostic triad for the detection of prostatic carcinoma. About 50 years ago, Dr. Donald Gleason created a grading system for prostate cancer based on its histologic patterns. Currently, this system maintains its validity with various changes. New updates were made in 2005 and 2014 by the International Society of Urological Pathology. The goal of biopsies is to determine the Gleason score and prognosis in prostatectomy material. The aim of this study was to determine the concordance of the Gleason score, tumor volume and tumor laterality between prostate needle biopsy and prostatectomy materials.
The study was performed with 112 patients who had biopsy and prostatectomy materials. The Gleason grades of the tumors have been evaluated with the new grading system. Tumor volumes were calculated by the number of positive blocks while tumor laterality was evaluated as unilateral or bilateral. Statistical analysis was performed on the obtained data.
Gleason score, tumor volume and tumor laterality discordance between needle biopsy and prostatectomy materials was found to be statistically significant. However, the concordance increased as the Gleason score and tumor volume increased.
Digital examination, serum prostate specific antigen value and needle biopsy together are very sensitive for a prostate adenocarcinoma diagnosis. The Gleason score, localization and volume of the tumors are important for patient follow-up, treatment and prognosis.
前列腺癌是男性中第二常见的癌症。直肠指检、经直肠超声检查和血清前列腺特异性抗原是检测前列腺癌的诊断三联征。大约50年前，唐纳德·格里森博士基于前列腺癌的组织学模式创建了一种分级系统。目前，该系统在经过各种修改后仍然有效。国际泌尿病理学会在2005年和2014年进行了新的更新。活检的目的是确定前列腺切除标本中的格里森评分和预后。本研究的目的是确定前列腺穿刺活检标本与前列腺切除标本之间格里森评分、肿瘤体积和肿瘤侧别方面的一致性。
对112例同时有活检和前列腺切除标本的患者进行了研究。采用新的分级系统对肿瘤的格里森分级进行评估。肿瘤体积通过阳性组织块数量计算，而肿瘤侧别评估为单侧或双侧。对所得数据进行统计学分析。
发现穿刺活检标本与前列腺切除标本之间的格里森评分、肿瘤体积和肿瘤侧别不一致具有统计学意义。然而，随着格里森评分和肿瘤体积的增加，一致性也有所提高。
直肠指检、血清前列腺特异性抗原值和穿刺活检共同对前列腺腺癌诊断非常敏感。肿瘤的格里森评分、定位和体积对患者的随访、治疗及预后很重要。
