| Objective: To investigate the clinical factors that can predict Gleason score upgrading after receiving radical prostatectomy in both the 2005 ISUP modified Gleason score and the 2014 ISUP Gleason Score Prognostic Grade Groups(GGGs) separately.Method: Retrospectively analyzed 133 patients with prostate cancer who received radical prostatectomy from January 2011 to January 2016 at Department of Urology at Tongji Hospital of Tongji Medical College of HUST, including clinical factors such as age, BMI, cholesterol, PI-RADS score, prostate volume, peripheral zone volume, t PSA, f PSA/t PSA, PSAD, PSAD of peripheral zone, biopsy GS, RP GS, percentage positive core, clinical staging, risk groups and other pathological characteristics. Univariable and multivariable logistic regression was used to identify predictors of GS upgrading. ROC curve for predictive power of PZPSAD was generated along with the AUC calculating.Result: In 2005 ISUP modified Gleason score, no difference in GS was noted in 44 cases(33.08%), while a upgrade in 50 cases(37.59%) and downgrade in 39 cases(29.33%). Biopsy GS(P=0.039) and PZPSAD(P=0.029) were significantly correlated with GS upgrading. ROC analysis showed an AUC of 0.657 and a cut-off value of PZPSAD of 3.03. In 2014 ISUP Gleason Score Prognostic Grade Groups(GGGs), no difference in GS was noted in 50 cases(37.59%), while an upgrade in 48 cases(36.09%) and downgrade in 35 cases(26.32%). Biopsy GGGs(P=0.004) and PCa risk groups(P=0.006) were significantly correlated with GGGs upgrading.Conclusion: In 2005 ISUP modified Gleason score, GS upgrading may occur when biopsy GS≤7 or PZPSAD>3.03. In 2014 ISUP Gleason Score Prognostic Grade Groups, GGGs upgrading may occur when biopsy GGGs≤3 or in low-risk and intermediate-risk PCa patients. This fact should be kept in mind while making therapeutic decisions. |
