Mills S E, Fowler J E
Cancer. 1986 Jan 15;57(2):346-9. doi: 10.1002/1097-0142(19860115)57:2<346::aid-cncr2820570226>3.0.co;2-e.
The Gleason histologic score of prostatic adenocarcinoma in biopsy specimens (needle cores or transurethral chips) was compared with the Gleason score of corresponding radical prostatectomy specimens from 53 patients with localized prostatic carcinoma. The Gleason score assigned to the biopsy specimen was identical to that of the prostatectomy specimen in 51% of cases, was greater than that of the prostatectomy specimen in 4%, and was less than that of the prostatectomy specimen in 45%. The magnitude of discrepancy between the scores of the biopsy specimen and the prostatectomy specimen was directly related to the quantity of neoplastic tissue in the biopsy specimen. Discrepancies between the Gleason score of biopsy material and prostatectomy specimens were greater among biopsy specimens with low Gleason scores as compared with biopsy specimens with high Gleason scores. Given the small number of cases, these differences were not statistically significant. Clinical understaging of the primary tumor did not correlate with histologic undergrading of the prostatectomy specimen. It was concluded that prostatic biopsy should be repeated when the initial diagnosis of adenocarcinoma is based on only limited quantities of neoplastic tissue with a low Gleason score and management decisions may be influenced by the true Gleason score of the tumor.
对53例局限性前列腺癌患者活检标本（穿刺活检组织条或经尿道切除组织块）中前列腺腺癌的Gleason组织学评分与相应根治性前列腺切除术标本的Gleason评分进行了比较。在51%的病例中，活检标本的Gleason评分与前列腺切除术标本的评分相同，4%的病例中活检标本的评分高于前列腺切除术标本，45%的病例中活检标本的评分低于前列腺切除术标本。活检标本与前列腺切除术标本评分之间的差异程度与活检标本中肿瘤组织的量直接相关。与高Gleason评分的活检标本相比，低Gleason评分的活检标本中活检材料与前列腺切除术标本的Gleason评分之间的差异更大。鉴于病例数较少，这些差异无统计学意义。原发肿瘤的临床分期不足与前列腺切除术标本的组织学分级不足无关。得出的结论是，当腺癌的初始诊断仅基于少量低Gleason评分的肿瘤组织，且治疗决策可能受肿瘤真实Gleason评分影响时，应重复进行前列腺活检。
