穿刺标本Gleason评分预测前列腺癌分级的准确性评价  

Evaluation of Gleason grading as compared to histological grading of radical prostatectomy specimens of prostate cancer

作　　者：李贵忠[1] 曾荔[1] 张军[1] 袁亦铭[1] 杨新宇[1] 那彦群[1] 郭应禄[1] 

机构地区：[1]北京大学第一医院泌尿外科,北京大学泌尿外科研究所,100034

出　　处：《中华泌尿外科杂志》2003年第12期821-823,共3页Chinese Journal of Urology

摘　　要：目的　探讨前列腺穿刺标本Gleason评分预测前列腺癌分级准确性的价值及影响因素。　方法　对 45例临床局限性前列腺癌患者前列腺穿刺标本与根治术标本Gleason评分一致性进行比较 ,并对影响一致性的可能因素进行相关分析。　结果　 45例穿刺标本与根治术标本Gleason评分相符者 19例 (42 % ) ;评分偏低 2 2例 (49% ) ,其中偏低 1分 10例 (2 2 % ) ,偏低 >2分 12例 (2 7% ) ;评分偏高 4例 (9% )。二者具有一致性 ,但一致性稍差 (K =0 .3 4 2 ,P <0 .0 1)。偏差与患者年龄、前列腺体积、TPSA、穿刺阳性针数比例、分级及病理分期均无显著相关性 (P >0 .0 5)。前列腺穿刺阳性针数比例在精囊浸润和非浸润组差异有显著性意义 (P <0 .0 5) ,尤其在Gleason评分 >7分时差别有非常显著性意义 (P <0 .0 1)。　结论　穿刺标本Gleason评分结合临床其他资料能有效地指导临床治疗。结合前列腺穿刺阳性针数比例 。ObjectiveTo evaluate Gleason grading of bi opsy specimens as compared to the histological grading of radical prostatectomy specimens of prostate cancer and to analyze the possible factors that might res ult in grading error of biopsy.MethodsGleason scores o f needle biopsies were compared to those of radical prostatectomy specimens in 4 5 consecutive patients.In addition,the possible factors correlated with grading error of biopsy were analyzed.ResultsThe biopsy score was identical to the specimen scores in 42% (19/45) of cases. 49% (22/45) of bio psies were under graded, while 9% (4/45) were over graded. There was no correlat ion of grading error with pathological stage,grade,serum PSA level,prostatic vol ume and the percent positive prostate biopsies ( P >0.05).The percent positive prostate biopsies was significantly higher in patients with seminal vesicle inv asion than that with organ-confined ( P <0.05).ConclusionsCombined with other data,the Gleason grading based on biopsy was effecti ve when considering treatment options.High Gleason score biopsies with the perce ntage of positive needle biopsies (≥50%) were risk factors for seminal vesicle invasion.

关 键 词：穿刺标本 GLEASON评分 预测 前列腺癌 分级 准确性 评价 

分 类 号：R737.25[医药卫生—肿瘤]