Thomas R, Lewis R W, Sarma D P, Coker G B, Rao M K, Roberts J A
J Urol. 1982 Oct;128(4):726-8. doi: 10.1016/s0022-5347(17)53156-0.
Recently, pathologic staging systems have been used to aid in accurate clinical assignment of prostatic disease. With this in mind, we reviewed retrospectively 130 patients who were diagnosed as having prostatic cancer either by needle biopsy or by study of transurethral resection chips. These specimens were graded by the Gleason and Roswell Park histopathologic grading systems. Grading was done by 2 pathologists independently and without knowledge of the results of final surgical staging. All patients were without evidence of metastases by standard diagnostic studies, and all underwent pelvic lymphadenectomy and radical prostatectomy if nodes were grossly negative. The surgical specimens were examined and the final clinical stage was correlated with the histopathologic grading. Independently, the Gleason rather than the Roswell Park system was slightly more accurate and was a more reliable predictor of the surgical stage of the disease. Of the patients with a Gleason sum of 7 or above 86 per cent had at least stage C disease, whereas the disease had been staged preoperatively as A or B. All patients with a Gleason sum of 2 to 5 had stage A or B disease.
最近，病理分期系统已被用于辅助前列腺疾病的准确临床诊断。考虑到这一点，我们回顾性研究了130例经针吸活检或经尿道切除组织块检查诊断为前列腺癌的患者。这些标本按照 Gleason 和罗斯韦尔帕克组织病理学分级系统进行分级。分级由两名病理学家独立完成，且他们不知道最终手术分期的结果。所有患者经标准诊断检查均无转移迹象，若淋巴结大体检查为阴性，则均接受盆腔淋巴结清扫术和根治性前列腺切除术。对手术标本进行检查，并将最终临床分期与组织病理学分级进行关联。独立来看，Gleason 系统而非罗斯韦尔帕克系统稍微更准确一些，并且是该疾病手术分期的更可靠预测指标。Gleason 评分总和为7或高于7的患者中，86% 至少患有C期疾病，而术前疾病分期为A或B期。所有 Gleason 评分总和为2至5的患者均患有A期或B期疾病。
