Study On The Consistency Of Gleason Score Between Prostate Biopsy Specimens And Specimens After Radical Prostatectomy

ObjectiveTo investigate the consistency of Gleason scores between saturation transperineal ultrasound guided template prostate biopsy specimens and radical specimens of prostate cancer after radical resection,and to analyze age,pre-puncture prostate volume(PV),pre-puncture PSA levels,pre-puncture PSA density,and percentage of positive core.And to figure out whether objective indicators such as clinical staging,prostate cancer risk factor grading group,lymph node metastasis,seminal vesicle invasion,etc.had effect on the score differences before and after radical mastectomy.MethodsData of 116 patients undergoing percutaneous perineal template localization prostate saturation biopsy confirmed as PCa and underwent radical mastectomy from January 2016 to December 2017 in our hospital were collected and analysed.The 2005 ISUP Gleason grading system and the 2014 ISUP Gleason grading systemwere used respectively.T-test and chi-square test was used to compare relevant data,and logistic regression analysis was performed on the above multiple objective indicators to figure out the roles they played in the differences of GS group between biopsy specimens and radical specimens.ResultsAmong the 116 patients,the coincidence rate of GS group between biopsy specimens and radical specimens was 59.48%(69),while the overestimating rate and underestimating rate of biopsy specimens was 7.76%(9)and 32.76%(38),respectively.The difference was statistically significant(P<0.05).Further logistic regression analysis showed that the risk factors of PV,PCa,grade of puncture GS,and percentage of positive biopsy cores were statistically significant(P<0.05).Further Logistics multifactorial Regression analysis showed that puncture GGGs(P=0.007),PCa risk factors grading group(P=0.013),and PV(P=0.027)were independent predictors of GS grading elevation after radical prostatectomy.ConclusionsCompared with the 2005 ISUP Gleason score system,the PB specimens pathology are more consistent with the RP specimens pathology in the 2014 ISUP Gleason Score Prognostic Grade Groups.In 2005 ISUP Gleason score system,when biopsy specimens GS ? 7,the possibility of pathological upgrade will probably increase after radical prostatectomy.In 2014 ISUP Gleason Score Prognostic Grade Groups,when biopsy specimens GS group ? 3,GS group-level elevation is prone to occur after radical surgery.When faced with such situation,we should consider the limitations of the pathology report of puncture specimens,and had better perform comprehensive assessment of the patients in combination with relevant imaging examinations.In order to avoid underestimating the real condition of the patients and delaying treatment,it is also possible to use fusion targeting biopsy to obtain more comprehensive and reliable pathological results.