Department of Urology, Melikgazi Hospital, Kayseri, Turkey
Department of Urology, Training and Research Hospital, Ahi Evran University, Kırşehir, Turkey
Turk J Med Sci. 2021 Jun 28;51(3):1360-1364. doi: 10.3906/sag-2009-73.
BACKGROUND/AIM: The aim of this study was to establish the relationship between the needle biopsy and the pathology result after radical prostatectomy administrated for prostate cancer.
We retrospectively analyzed 67 patients who had undergone radical prostatectomy from 2016 to 2019. All sur- geries and all biopsies were performed in the third author’s urology department. Samples were collected through 12-core biopsy under local anesthesia. All specimens were studied in the pathology department of the third author’s center. The results evaluated were needle biopsies’ Gleason scores and prostatectomy specimens’ Gleason scores.
Inclusion criteria were not having any neo-adjuvant treatment and being treated with surgery after needle biopsy. Gleason scores obtained from needle biopsies and prostatectomy specimens were evaluated. The comparison revealed that 39% of the tumors were undergraded, 7% were overgraded, and 54% had exact scoring in needle biopsies and prostatectomy specimens according to the detailed Gleason scoring as primary and secondary metrics. The patients were grouped into five categories according to the ISUP 2014 prostate cancer grading system. The relationship was strong with 64% of results staying in the same group after the operation; neverthe- less, the correlation remained weak based on the kappa coefficient.
The information obtained from the needle biopsy is not a strong herald of the pathological result. Urologists should have awareness of this restraint when utilizing the needle biopsy’s Gleason score in decision making and treatment planning.
背景/目的:本研究旨在建立前列腺癌根治性前列腺切除术后针吸活检与病理结果之间的关系。
我们回顾性分析了 2016 年至 2019 年期间接受根治性前列腺切除术的 67 例患者。所有手术和所有活检均由第三作者的泌尿科进行。在局部麻醉下通过 12 核活检采集样本。所有标本均在第三作者中心的病理科进行研究。评估的结果是针吸活检的 Gleason 评分和前列腺切除术标本的 Gleason 评分。
纳入标准为无新辅助治疗且经针吸活检后行手术治疗。评估了针吸活检和前列腺切除术标本中的 Gleason 评分。比较结果显示,根据主要和次要指标的详细 Gleason 评分,39%的肿瘤分级降低,7%的肿瘤分级升高,54%的肿瘤分级在针吸活检和前列腺切除术标本中评分相同。根据 ISUP 2014 前列腺癌分级系统,将患者分为五类。术后有 64%的结果保持在同一组,相关性较强;然而,根据kappa 系数,相关性仍然较弱。
针吸活检获得的信息并不是病理结果的有力预示。泌尿科医生在决策和治疗计划中使用针吸活检的 Gleason 评分时,应该意识到这一限制。