The Risk Factors Analysis Of Needle Biopsy Gleason Scores Upgrading After Radical Prostatectomy

Objective To investigate the factors predictive of Gleason score upgrading between biopsy and surgical specimens. Methods A total of164patients diagnosed as prostate cancer by biopsy who underwent radical prostatectomy between January2010and December2013at our institution were enrolled in this study. For the purpose of analysis,the data were divided into two groups:upgraded group and non upgraded group. Univariate and multivariate logistic regression analysis was used to determine predictors of Gleason score upgrading. Results Compared to the Gleason score of prostatectomy specimens, that of biopsy specimens was concordant in95(57.39%), higher in55(33.54%) and lower in14(8.52%) patients. According to univariate logistic regression analysis, prostate volume, PSAD, clinical stage and biopsy score were significantly associated with Gleason score upgrading(P <0.05). While the age, the numbers of positive needle, preoperative PSA, positive surgical margin, seminal vesicle invasion, lymphatic invasion, the time interval between biopsy and surgery were not(P>0.05). And according to multivariate Logistic regression analysis, prostate volume (P <0.001) and biopsy score (P=0.032) are the independent predictors of GS upgrading. Conclusion In our study, smaller prostate volumes and lower biopsy score(GS≤6) were at increased risk for GS upgrading after RP.