Analysis Of Related Factors Of Pathological ISUP Grade Upgrading After Radical Prostatectomy

Objective: To study the frequency and distribution of ISUP grade upgrading events after radical prostatectomy compared with puncture biopsy,and to find out the factors related to ISUP grade upgrading after radical prostatectomy from preoperative information.Methods: The frequency and distribution of pathological ISUP grade upgrading events after radical prostatectomy were studied by investigating the information of patients undergoing radical prostatectomy from 2012 to 2018.Univariate analysis and multivariate logistic regression analysis were used to screen for preoperative related factors to assess the possibility of ISUP grade upgrading after surgery.According to these preoperative related factors,nomogram was constructed to facilitate clinical application.Results: Of the 177 selected patients,65(36.72%)were upgraded,mainly in ISUP Grade 1-3 of biopsy pathology,accounting for 76.92%(n=50)of the total upgraded patients.Multivariate regression analysis of patient with biopsy pathological ISUP Grade ?3 showed that preoperative total PSA,positive percentage of biopsy core,prostate volume and ISUP grade of puncture pathology were significantly correlated with ISUP grade upgrading events(P<0.05).According to the regression model,the overall correct rate of Norman chart is 83.6%,which can better reflect the actual situation.Conclusion: Patients with biopsy pathology ISUP grade < 3 have higher risk of pathological upgrading after operation.The high preoperative total PSA and percentage of biopsy core are the risk factors of pathological upgrading after operation.The patients with high ISUP grade or large volume prostate and puncture pathology have less possibility of pathological upgrading after operation.