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[前列腺穿刺活检报告——病理学家提供的内容及泌尿科医生想要的内容]

[Reports of prostate needle biopsies-what pathologists provide and urologists want].

作者信息

Offermann A, Hupe M C, Joerg V, Sailer V, Kramer M W, Merseburger A S, Tharun L, Perner S

机构信息

Institut für Pathologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Universität zu Lübeck, Ratzeburger Allee 160 (Haus 50), 23538, Lübeck, Deutschland.

Klinik für Urologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Deutschland.

出版信息

Urologe A. 2020 Apr;59(4):461-468. doi: 10.1007/s00120-020-01121-z.

Abstract

BACKGROUND

The prostate biopsy report is key for risk stratification of prostate cancer patients and subsequent therapeutic decision-making. However, due to the inclusion of a multitude of additional parameters its interpretation is becoming more challenging.

OBJECTIVES

We aimed to determine how urologists currently interpret prostate biopsy reports, in particular how they consider different histopathological parameters for therapy decision-making.

MATERIALS AND METHODS

A survey was sent to all urology practices in Germany with the help of the BDU (Berufsverband der Deutschen Urologen e. V.). In total, there were 106 complete responses that could be included for further analyses.

RESULTS

Most urologists consider the number of positive cores and relative tumor burden (%) per core as crucial for the assessment of tumor extension. In case of targeted biopsies, the majority of urologists prefers a separate statement of positive cores per random biopsy scheme and per region of interest, respectively. The core with the highest Gleason score is mostly the basis for therapy decision-making (versus the overall Gleason score). Proportion of Gleason 4 pattern also seems to be critical for prostate cancer management. Only half of the urologists demand reporting of the new ISUP/WHO (International Society of Urological Pathology/World Health Organization) grade groups. Additional parameters claimed are Ki67, prostate-specific membrane antigen status, presence of intraductal or neuroendocrine component of the tumor.

CONCLUSIONS

Our survey shows that there is no standardized reporting for prostate biopsies and that the interpretation of prostate biopsy reports varies among urologists. Further studies and guideline recommendations are necessary to establish a standardized reporting scheme for prostate biopsies.

摘要

背景

前列腺活检报告是前列腺癌患者风险分层及后续治疗决策的关键。然而,由于包含众多额外参数,其解读变得更具挑战性。

目的

我们旨在确定泌尿外科医生目前如何解读前列腺活检报告,尤其是他们在治疗决策中如何考虑不同的组织病理学参数。

材料与方法

在德国泌尿外科学会(BDU,Berufsverband der Deutschen Urologen e. V.)的帮助下,向德国所有泌尿外科诊所发送了一份调查问卷。总共收到106份完整回复,可纳入进一步分析。

结果

大多数泌尿外科医生认为阳性活检芯数量及每个活检芯的相对肿瘤负荷(%)对评估肿瘤范围至关重要。对于靶向活检,大多数泌尿外科医生倾向于分别针对每个随机活检方案和每个感兴趣区域单独列出阳性活检芯情况。治疗决策大多基于 Gleason 评分最高的活检芯(而非总体 Gleason 评分)。Gleason 4级模式的比例似乎对前列腺癌管理也很关键。只有一半的泌尿外科医生要求报告新的国际泌尿病理学会/世界卫生组织(ISUP/WHO)分级组。其他要求报告的参数有Ki67、前列腺特异性膜抗原状态、肿瘤导管内或神经内分泌成分的存在情况。

结论

我们的调查表明,前列腺活检尚无标准化报告,且泌尿外科医生对前列腺活检报告的解读存在差异。需要进一步研究和指南建议来建立前列腺活检的标准化报告方案。

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