前列腺癌穿刺活检与根治术后标本Gleason评分及病理分期的差异性研究  

Study on the difference of Gleason score and pathological staging between prostate biopsy specimens and radical resection specimens

作　　者：金鑫[1,2] 赵文超[2] 周鹏[2] 郑明华[2] 牛天力[2] 陈明[1] JIN Xin ZHAO Wen- chao ZHOU Peng ZHENG Ming- hua NIU Tian-li CHEN Ming(Department of Urology, Zhongda Hospital, Southeast University, Nanfing 210009, China Department of Urology, the Affiliated Taizhou People＇s Hospital of Nantong University, Taizhou 225300, China)

机构地区：[1]东南大学附属中大医院泌尿外科,江苏南京210009 [2]南通大学附属泰州市人民医院泌尿外科,江苏泰州225300

出　　处：《现代医学》2016年第12期1685-1688,共4页Modern Medical Journal

摘　　要：目的:探讨前列腺癌穿刺活检与根治术后标本Gleason评分及病理分期的差异性,并分析差异的成因。方法:采用回顾性分析方法,比较120例前列腺癌患者术前前列腺穿刺活检与根治术后标本Gleason评分及病理分期的差异,并通过Logistic回归分析造成差异的原因。结果:120例患者中,术前穿刺与术后标准Gleason存在差异的患者有50例,占41.7%。单因素回归分析发现,前列腺特异抗原密度(PSAD)、穿刺Gleason评分、前列腺体积、穿刺阳性针数与根治术后Gleason评分的差异性显著相关(P<0.05)。多因素回归分析发现,穿刺评分和前列腺体积是Gleason评分差异性的独立预测因子(P<0.05)。结论:前列腺癌穿刺活检与根治术后标本Gleason评分具有一定的差异性,这种差异的存在可能会导致患者选择不当的治疗方案,所以在日后的治疗中需选择更合理的穿刺方案以降低穿刺与术后标本Gleason评分的差异性。Objective： To find the difference of Gleason score and pathological staging between prostate biopsy specimens and radical resection specimens and to analyze the causes of the difference.Methods： Retrospective analysis was done in 120 prostate cancer patients.The difference of Gleason score and pathological staging between prostate biopsy specimens and radical resection specimens and the causes of differences were compared and analyzed respectively by Logistic analysis.Results： The difference in Gleason score and pathological staging between prostate biopsy specimens and radical resection specimens was found in 50 patients（ 41.7%）.Single factor analysis showed that PSDA,biopsy Gleason score,prostate volume and positive needle number of biopsy were prominently associated with Gleason score after radical resection with significant difference.Multiple factor analysis suggested that the biopsy Gleason score and prostate volume were independent predictors of the difference（ P 〈 0.05）.Conclusion： There are some differences between Gleason score of prostate biopsy and that of radical prostatectomy specimens,which could affect the choice of treatment,so more reasonable approach of prostate biopsy should be chosen to reduce the difference.

关 键 词：前列腺癌 GLEASON评分 病理分期 

分 类 号：R737.25[医药卫生—肿瘤]