Analysis Of The Differences In Prostate Cancer Biopsy And Postoperative Pathological Grade And The Influencing Factors Of Postoperative Pathological Upgrading

Objective:To analyze the consistency of prostate biopsy pathology and pathological grade after radical resection,and to explore the risk factors of postoperative pathological upgrade,and to establish a model to predict postoperative pathological upgrade,which will be of guiding significance for the management of patients with prostate cancer.Methods:Retrospective analysis of 174 cases of prostate biopsy performed in our hospital from January 2014 to December 2018 and radical prostatectomy in our hospital;According to the relationship between biopsy pathology and postoperative pathology,it is divided into degraded group / consistent group / upgrade group(A / B / C).The biopsy pathology and postoperative pathological Gleason score distribution were analyzed in group A+B and B+C,respectively.We compared the differences in age,prostate volume(PV),biopsy Gleason score,percentage of biopsy positive needles,PSA and other factors between groups B and C,whether it was statistically significant.To study the influencing factors of postoperative pathological upgrade in patients with prostate cancer.According to multi-factor analysis,the independent risk factors of postoperative pathological improvement of prostate cancer were analyzed,and a model for predicting postoperative pathological improvement was established.Results:The statistical data of our hospital showed that the coincidence rate of prostate biopsy pathology and postoperative radical pathology was about 51.7%,postoperative pathological upgrade was about 32.8%,and postoperative pathology was about 15.5% lower than preoperative.There was no significant difference in the distribution of GS between postoperative and biopsy in group A+B.(P=0.29>0.05),there was no statistical significance in considering postoperative pathological degrading;At the same time,the distribution of postoperative and biopsy GS in the B+C group was statistically significant(P<0.05).Univariate and multivariate analysis showed that only the Gleason score,the percentage of puncture positive needles,and the prostate volume(PV) were independent influencing factors of postoperative pathological progression in patients with prostate cancer,and a predictive model for predicting postoperative pathological escalation was established.Conclusion:The biopsy pathology and the postoperative pathological grade are not consistent,especially the postoperative pathological grade escalation is more common.Among them,age,PSA,percentage of puncture-positive needles,PSAD,puncture and operation time interval,surgical procedure,clinical stage,and puncture nerve invasion were not related to postoperative pathological escalation.Low biopsy Gleason score,higher percentage of puncture-positive needles and small prostate volume are independent risk factors for postoperative pathological upgrade.The Nomogram model was established to predict the postoperative pathological progression of prostate cancer to better guide clinical treatment.