1996年至2019年前列腺癌患者Gleason评分变化趋势的探索：一项回顾性单中心研究

Exploration on Gleason score variation trend of patients with prostate carcinoma from 1996 to 2019: a retrospective single center study.

作者信息

Zhang Weiyu, Wang Gongwei, Lan Fengling, Wang Huanrui, Shen Danhua, Xu Kexin, Xu Tao, Hu Hao

机构信息

Department of Urology, Peking University People's Hospital, Beijing, China.

Department of Pathology, Peking University People's Hospital, Beijing, China.

出版信息

Gland Surg. 2021 Feb;10(2):607-617. doi: 10.21037/gs-20-659.

DOI:10.21037/gs-20-659

PMID:33708544

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7944060/

Abstract

BACKGROUND

Gleason score (GS) is one of the stronger prognostic factors and is integral to the management of prostate carcinoma. Subsequent modifications, recommended by the International Society of Urological Pathology in 2005 and 2014, enabled accurate prediction of prognosis. The present study investigated GS variation trend of patients with prostate carcinoma from 1996 to 2019 and offered an overview of GS changes with age, specimen type, histopathological type and serum prostate specific antigen (PSA).

METHODS

One thousand three hundred and seventy-six patients, admitted to Peking University People's Hospital in 1996 to 2019, were divided into 1996 to 2006, 2007 to 2015 and 2016 to 2019 groups. Data, including demographic characteristics, GS, primary and secondary grade and percentage of primary and secondary grade of each group, were collected and analyzed. The population distribution and average of GS was evaluated, after segmented and stratified by age, type of specimen, histopathological type and PSA.

RESULTS

The average of age and PSA of each cohort had no obvious change. The average of total GS fluctuated among three cohorts with statistically significant differences. The distribution of age and PSA did not differ among cohorts. The distribution of total and primary GS shifted, with more patients detected as total GS higher than 6 (86.1%), and more primary grade higher than 3 (56.7%) in 2016-2019. After segmented and stratified by age, specimen type, histological type and PSA, the population percentage of GS over 6 was significantly higher in 2016-2019 than 1996-2006 and 2007-2015 in patients aged younger than 80 years (age <60, 89.6%, age 60-69, 82.0%, age 70-79, 87.7%). Patients, aged below 80 years in 2016-2019, were detected with higher total GS.

CONCLUSIONS

In the present study, GS in patients with prostate carcinoma showed a upward trend. Primary grade, age, serum PSA and specimen type were the main reasons for GS changing while secondary grade, tissue types and diagnostic criteria influenced less.

摘要

背景

Gleason评分（GS）是较强的预后因素之一，是前列腺癌管理的重要组成部分。国际泌尿病理学会在2005年和2014年推荐的后续修订，使得能够准确预测预后。本研究调查了1996年至2019年前列腺癌患者的GS变化趋势，并概述了GS随年龄、标本类型、组织病理学类型和血清前列腺特异性抗原（PSA）的变化情况。

方法

1996年至2019年在北京大学人民医院住院的1376例患者被分为1996年至2006年、2007年至2015年和2016年至2019年三组。收集并分析包括人口统计学特征、GS、主要和次要分级以及每组主要和次要分级百分比的数据。在按年龄、标本类型、组织病理学类型和PSA进行分段和分层后，评估GS的总体分布和平均值。

结果

各队列的年龄和PSA平均值无明显变化。三个队列中总GS平均值波动，差异有统计学意义。各队列间年龄和PSA分布无差异。总GS和主要GS的分布发生了变化，2016 - 2019年检测到更多总GS高于6（86.1%）以及更多主要分级高于3（56.7%）的患者。在按年龄、标本类型、组织学类型和PSA进行分段和分层后，2016 - 2019年年龄小于80岁（年龄<60岁，89.6%；年龄60 - 69岁，82.0%；年龄70 - 79岁，87.7%）的患者中GS超过6的人群百分比显著高于1996 - 2006年和2007 - 2015年。2016 - 2019年年龄低于80岁的患者检测到的总GS更高。