前列腺癌穿刺标本与术后标本病理分级的差异及影响因素分析  

The differences in pathological grade between prostate cancer puncture specimens and postoperative specimens and their influencing factors

作　　者：潘瑜 邬嘉波 李想 PAN Yu;WU Jiabo;LI Xiang(Zhoushan Hospital,Zhoushan 316004,China)

机构地区：[1]舟山医院,浙江舟山316004

出　　处：《浙江实用医学》2023年第2期100-103,共4页Zhejiang Practical Medicine

摘　　要：目的探讨前列腺癌超声引导下经直肠前列腺穿刺标本与术后标本病理分级的差异及影响因素。方法选择2016年1月~2023年3月浙江省舟山医院经病理确诊的前列腺癌患者119例。检验患者穿刺标本的诊断一致性并计算Kappa值,依据患者穿刺活检与术后病理结果分为符合组(n=90)和不符组(n=29),比较两组临床资料差异,采用多因素Logistic回归分析探讨Gleason分级差异的独立影响因素。结果穿刺活检总符合率为75.63%,Kappa=0.803。患者TPSA(OR=4.154,95%CI:2.327—8.016,P=0.011)、活检阳性针数<6个(OR=3.116,95%CI:1.149—5.938,P=0.007)是Gleason分级差异的独立危险因素,前列腺体积(OR=0.676,95%CI:0.346—0.851,P=0.005)是保护因素。结论TPSA升高、活检阳性针数<6个、前列腺体积较小的患者其穿刺标本与术后标本病理分级存在差异的风险较高。Objective To investigate the differences and influencing factors between the pathological grading of prostate cancer transrectal prostate puncture specimens and postoperative prostate cancer specimens under ultrasound guidance.Methods A total of 119 patients with prostate cancer diagnosed by pathology in Zhejiang Zhoushan Hospital of Zhejian Province from January 2016~March 2023 were enrolled.The diagnostic consistency of the patients was tested and the Kappa value was calculated,and the patients were divided into coincidence group(n=90)and non-conforming group(n=29)according to the pathological results of the needle biopsy and postoperative pathology,and the differences in clinical data between the two groups were compared,and the independent influencing factors of Gleason grade differences were explored by multivariate logistic regression analysis.Results The total coincidence rate of needle biopsy was 75.63%,and the Kappa value=0.803.TPSA(OR=4.154,95%CI:2.327—8.016,P=0.011)and<6 positive biopsy needles(OR=3.116,95%CI:1.149—5.938,P=0.007)were independent risk factors for Gleason grade differences,and prostate volume(OR=0.676,95%CI:0.346—0.851,P=0.005)was a protective factor.Conclusion Patients with elevated TPSA,<6 positive biopsy needles,and small prostate volume have a higher risk of pathological grade difference between the puncture specimen and the postoperative specimen.

关 键 词：前列腺癌 超声引导 经直肠前列腺穿刺 病理分级 

分 类 号：R737.25[医药卫生—肿瘤]