Fiorentino Vincenzo, Martini Maurizio, Dell'Aquila Marco, Musarra Teresa, Orticelli Ersilia, Larocca Luigi Maria, Rossi Ernesto, Totaro Angelo, Pinto Francesco, Lenci Niccolò, Di Paola Valerio, Manfredi Riccardo, Bassi Pier Francesco, Pierconti Francesco
Institute of Pathology, Università Cattolica del S. Cuore, Fondazione Policlinico "A. Gemelli", 00168 Rome, Italy.
Institute of Medical Oncology, Università Cattolica del S. Cuore, Fondazione Policlinico "A. Gemelli", 00168 Rome, Italy.
Diagnostics (Basel). 2020 Dec 23;11(1):10. doi: 10.3390/diagnostics11010010.
Biopsy proven Gleason score is essential to decide treatment modalities for prostate cancer, either surgical (radical prostatectomy) or non-surgical (active surveillance, watchful waiting, radiation therapy and hormone therapy). Several studies indicated that biopsy proven Gleason score may underestimate Gleason score at radical prostatectomy, hence we aimed to calculate the minimum length of biopsy cores needed to have Gleason score agreement. We evaluated 115 prostate cancer patients who underwent multiparametric magnetic resonance/transperineal ultrasonography fusion biopsy and subsequently, radical prostatectomy. Biopsy proven Gleason score was consistent with Gleason score at subsequent radical prostatectomy in 82.6% of patients, while in 17.4% of patients, Gleason score was higher at radical prostatectomy. Gleason score agreement showed a strong direct association with a ratio > 0.05 between the total volume of biopsies performed in tumor area and the volume of the corresponding tumor at radical prostatectomy. A significant association was also found with a ratio ≥ 0.0034 between the tumor volume in the biopsy and the volume of the corresponding tumor at radical prostatectomy and with a ratio ≥ 0.086 between the tumor volume in the biopsy and the total volume of biopsies performed in the tumor area. These results could be exploited to calculate the minimum length of biopsy cores needed to have a correct Gleason score estimation and therefore be used in fusion targeted biopsies with volume adjustments.
经活检证实的Gleason评分对于决定前列腺癌的治疗方式至关重要，无论是手术治疗（根治性前列腺切除术）还是非手术治疗（主动监测、观察等待、放射治疗和激素治疗）。多项研究表明，经活检证实的Gleason评分可能会低估根治性前列腺切除术中的Gleason评分，因此我们旨在计算获得Gleason评分一致性所需的活检组织芯的最短长度。我们评估了115例接受多参数磁共振/经会阴超声融合活检并随后接受根治性前列腺切除术的前列腺癌患者。在82.6%的患者中，经活检证实的Gleason评分与随后根治性前列腺切除术中的Gleason评分一致，而在17.4%的患者中，根治性前列腺切除术中的Gleason评分更高。Gleason评分一致性与肿瘤区域活检组织总体积与根治性前列腺切除术中相应肿瘤体积之比>0.05呈强正相关。在活检组织中的肿瘤体积与根治性前列腺切除术中相应肿瘤体积之比≥0.0034以及活检组织中的肿瘤体积与肿瘤区域活检组织总体积之比≥0.086之间也发现了显著相关性。这些结果可用于计算获得正确Gleason评分估计所需的活检组织芯的最短长度，因此可用于进行体积调整的融合靶向活检。
