前列腺癌术后病理Gleason评分升高的相关因素分析
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摘要
目的:探讨前列腺癌术后病理Gleason评分较术前穿刺评分升高的相关因素。方法:回顾性选择我院自2015年11月至2017年11月106例前列腺癌根治术患者临床资料,分析评分升高相关因素,如年龄、前列腺特异性抗原(PSA)、穿刺阳性针数、前列腺体积、穿刺评分等指标,统计分析术后与穿刺病理Gleason评分差异,采用Logistic回归筛选病理Gleason评分升高的因素。结果:106例患者中患者中24例出现术后病理Gleason评分升高,前列腺体积与前列腺癌术后病理Gleason评分升高相关。结论:体积较小的前列腺癌术后Gleason评分升高的可能性较大。术前测量前列腺体积可估算前列腺癌患者的真实Gleason评分,利于指导临床治疗。
Objective: To explore the risk factors for the upgrading of Gleason score radical prostatectomy(RP). Methods: The study cohort consisted of 106 men treated with RP. The patients' age, serum prostate specific antigen(PSA), positive rate of puncture, prostate volume, Gleason score, and changes of Gleason sore were analyzed. The risk factors of Gleason score upgrading were analyzed with Logistic regression. Result: Of all 106 patients, 24(22.6%)had upgraded Gleason sore. The prostate volume was independent predictor of Gleason score upgrading. Conclusion: Small prostate volume may be the predictor of Gleason score upgrading after RP. Preoperative measurement of prostate volume can be used to estimate the true Gleason score of prostate cancer patients, which is conducive to the guidance of clinical treatment.
Objective: To explore the risk factors for the upgrading of Gleason score radical prostatectomy(RP). Methods: The study cohort consisted of 106 men treated with RP. The patients' age, serum prostate specific antigen(PSA), positive rate of puncture, prostate volume, Gleason score, and changes of Gleason sore were analyzed. The risk factors of Gleason score upgrading were analyzed with Logistic regression. Result: Of all 106 patients, 24(22.6%)had upgraded Gleason sore. The prostate volume was independent predictor of Gleason score upgrading. Conclusion: Small prostate volume may be the predictor of Gleason score upgrading after RP. Preoperative measurement of prostate volume can be used to estimate the true Gleason score of prostate cancer patients, which is conducive to the guidance of clinical treatment.
引文
[1]epstein JI,Zelefsky MJ,sjoberg DD,et al.A contemporary prostate cancer grading system:a validated alternative to shr Gleason score[J].eur Urol,2016,69(3):428-435.
[2]eroglu M,Doluoglu o G,sarici H,et al.Does the time from biopsy to radical prostatectomy affect Gleason score upgrading in patients with clinical t1c prostate cancer?[J].Korean J Urol,2014,55(6):395-399.
[3]sarici H,tellio,Yigitbasi o,et al.Predictors of Gleason score upgrading in patients with prostate biopsy Gleason score≤6[J].cua J-can Urol Assoc,2014,8(5-6):e342.
[4]He B,chen R,Gao X,et al.nomograms for predicting Gleason upgrading in a contemporary chinese cohort receiving radical prostatectomy after extended prostate biopsy:development and internal validation[J].oncotarget,2016,7(13):17275-17285.
[5]capitanio UI,Karakicwicz PI,Valiquette L,et al.Biopsy core number represents one of foremost predictors of clinically significant gleason sumupgrading in patients with low-risk prostate cancer[J].Urology,2009,73(5):1087-1091.
[6]李连红,李冬阳,宋武,等.f Ps A/t Ps A预测前列腺癌术后Gleason评分升高的临床价值[J].现代泌尿外科杂志,2016,21(8):580-584.
[7]曾星,王志华,胡志全,等.Ps AD预测前列腺癌根治术后Gleason评分变化的临床应用价值[J].临床泌尿外科杂志,2013,28(1):10-12.
[8]truong M,slezak JA,Lin c P,et al.Development and multi-institutional validation of an upgrading risk tool for Gleason 6 prostate cancer[J].cancer,2013,119(22):3992-4002.
[9]Jalloh M,Myers F,cowan Je,et al.Racial variation in prostate cancer upgrading and upstaging among men with low-risk clinical characteristics[J].eur Urol,2015,67(3):451-457.
[10]Gershman B,Dahl DM,olumi AF,et al.smaller prostate gland size and older age predict Gleason score upgrading[J].Urol oncol,2013,31:1033-1037.
[11]Jin Bs,Kang s H,Kim DY,et al.Pathological upgrading in prostate cancer patients eligible for ective surveillance:Does patient-specific antigen density matter?[J].Korean J Urol,2015,56(9):624-629.
[12]epstein JI,Feng Z,trock BJ,et al.Upgrading and downgrading of prostate cancer from biopsy to radical prostatectomy:incidence and predictive factors using the modified Gleason grading system and factoring in tertiary grades[J].eur Urol,2012,61(5):1019-1024.
[13]Mohammed W,Davis n F,elamin s.et al.six-core versus twelve-core prostate biopsy:a retrospective study comparing accuracy.oncological outcomes and safety[J].Irish J Medsci,2016,185(1):219-223.
[14]chun FK,steuber t,erbersdobler A,et al.Development and internal validation of a nomogram predicting the probability of prostate cancer Gleason sum upgrading between biopsy and radical prostatectomy pathology[J].eur Urol,2006,49(5):820-826.
[2]eroglu M,Doluoglu o G,sarici H,et al.Does the time from biopsy to radical prostatectomy affect Gleason score upgrading in patients with clinical t1c prostate cancer?[J].Korean J Urol,2014,55(6):395-399.
[3]sarici H,tellio,Yigitbasi o,et al.Predictors of Gleason score upgrading in patients with prostate biopsy Gleason score≤6[J].cua J-can Urol Assoc,2014,8(5-6):e342.
[4]He B,chen R,Gao X,et al.nomograms for predicting Gleason upgrading in a contemporary chinese cohort receiving radical prostatectomy after extended prostate biopsy:development and internal validation[J].oncotarget,2016,7(13):17275-17285.
[5]capitanio UI,Karakicwicz PI,Valiquette L,et al.Biopsy core number represents one of foremost predictors of clinically significant gleason sumupgrading in patients with low-risk prostate cancer[J].Urology,2009,73(5):1087-1091.
[6]李连红,李冬阳,宋武,等.f Ps A/t Ps A预测前列腺癌术后Gleason评分升高的临床价值[J].现代泌尿外科杂志,2016,21(8):580-584.
[7]曾星,王志华,胡志全,等.Ps AD预测前列腺癌根治术后Gleason评分变化的临床应用价值[J].临床泌尿外科杂志,2013,28(1):10-12.
[8]truong M,slezak JA,Lin c P,et al.Development and multi-institutional validation of an upgrading risk tool for Gleason 6 prostate cancer[J].cancer,2013,119(22):3992-4002.
[9]Jalloh M,Myers F,cowan Je,et al.Racial variation in prostate cancer upgrading and upstaging among men with low-risk clinical characteristics[J].eur Urol,2015,67(3):451-457.
[10]Gershman B,Dahl DM,olumi AF,et al.smaller prostate gland size and older age predict Gleason score upgrading[J].Urol oncol,2013,31:1033-1037.
[11]Jin Bs,Kang s H,Kim DY,et al.Pathological upgrading in prostate cancer patients eligible for ective surveillance:Does patient-specific antigen density matter?[J].Korean J Urol,2015,56(9):624-629.
[12]epstein JI,Feng Z,trock BJ,et al.Upgrading and downgrading of prostate cancer from biopsy to radical prostatectomy:incidence and predictive factors using the modified Gleason grading system and factoring in tertiary grades[J].eur Urol,2012,61(5):1019-1024.
[13]Mohammed W,Davis n F,elamin s.et al.six-core versus twelve-core prostate biopsy:a retrospective study comparing accuracy.oncological outcomes and safety[J].Irish J Medsci,2016,185(1):219-223.
[14]chun FK,steuber t,erbersdobler A,et al.Development and internal validation of a nomogram predicting the probability of prostate cancer Gleason sum upgrading between biopsy and radical prostatectomy pathology[J].eur Urol,2006,49(5):820-826.