The prognostic significance of tertiary Gleason patterns of higher grade in radical prostatectomy specimens: a proposal to modify the Gleason grading system.
The prognostic significance of tertiary Gleason patterns of higher grade in radical prostatectomy specimens: a proposal to modify the Gleason grading system.
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根治性前列腺切除术标本中较高级别的三级格里森模式的预后意义：修改格里森分级系统的建议。
DOI：
10.1097/00000478-200004000-00011
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
Epstein,JI
中科院分区：
文献类型：
--
作者：
Pan,CC;Potter,SR;Partin,AW;Epstein,JI
前列腺腺癌的格里森分级系统没有考虑到第三级（第三最常见）模式的存在，并且没有关于后者的预后影响的研究。作者分析了 114 例具有小三级成分的根治性前列腺切除术，其中大部分占整个肿瘤的不到 5%。将这些标本与包含 2,276 例（不含三级成分）的前列腺切除术数据库进行比较。包含三级模式 4 或 5 的“典型”Gleason 评分 5 至 6 级肿瘤（Gleason 评分 2+ 3= 5、3+ 2= 5、3+ 3= 6）的病理分期显着高于不含模式 4 的“典型”Gleason 评分 5 至 6 级肿瘤（p= 0.018），但低于“典型”Gleason 评分 7 级肿瘤（p= 0.021；格里森分数，3+4=7，4+3=7)。具有三级模式 5 的典型 Gleason 评分 7 肿瘤的病理分期明显比没有模式 5 的典型 Gleason 评分 7 肿瘤 (p = 0.008) 更差，并且与典型 Gleason 评分 8 (Gleason 评分，4+4= 8) 肿瘤在统计学上没有差异。典型 Gleason 评分 5 至 6 分和具有三级成分的 7 级肿瘤均显示出比典型 Gleason 评分 5 至 6 级肿瘤 (p< 0.0001) 和没有三级成分的 Gleason 评分 7 级肿瘤 (p = 0.003) 显着更高的进展率，并且进展情况分别与典型 Gleason 评分 7 和 8 级肿瘤相似。三级高级成分对生物行为有不利影响。作者建议对用于根治性前列腺切除术标本的格里森系统进行修改，以考虑少量的模式 4 和 5，这对于预后很重要。
The Gleason grading system of prostatic adenocarcinoma does not account for the existence of a tertiary (third most prevalent) pattern, and there are no studies concerning the latter's prognostic influence. The authors analyzed 114 radical prostatectomies with small tertiary components, which mostly occupied less than 5% of whole tumors. These specimens were compared with a prostatectomy database comprised of 2,276 cases without a tertiary component. The pathologic stages of “typical” Gleason score 5 to 6 tumors (Gleason scores 2+ 3= 5, 3+ 2= 5, 3+ 3= 6), which contained tertiary patterns 4 or 5, were significantly higher than those of “typical” Gleason score 5 to 6 tumors without pattern 4 (p= 0.018) but lower than those of “typical” Gleason score 7 tumors (p= 0.021; Gleason scores, 3+ 4= 7, 4+ 3= 7). Typical Gleason score 7 tumors with a tertiary pattern 5 showed significantly worse pathologic stages than typical Gleason score 7 tumors (p= 0.008) without pattern 5 and were not different statistically from typical Gleason score 8 (Gleason score, 4+ 4= 8) tumors. Both typical Gleason score 5 to 6 and 7 tumors with tertiary components revealed significantly higher progression rates than typical Gleason score 5 to 6 tumors (p< 0.0001) and Gleason score 7 tumors (p= 0.003) without tertiary components, and progressed like typical Gleason score 7 and 8 tumors respectively. Tertiary high-grade components have an adverse impact on biologic behavior. The authors propose that the Gleason system for radical prostatectomy specimens be modified to take into account small volumes of patterns 4 and 5, which are important prognostically.
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影响因子：
6.6
作者：
OESTERLING, JE;BRENDLER, CB;WALSH, PC
通讯作者：
WALSH, PC
格里森分级系统：概述
DOI：
10.1385/jup:10:2:141
发表时间：
1999
期刊：
Journal of Urologic Pathology
影响因子：
--
作者：
W. Allsbrook;K. Mangold;Ximing J. Yang;J. Epstein
通讯作者：
J. Epstein
影响因子：
6.6
作者：
PARTIN, AW;EPSTEIN, JI;WALSH, PC
通讯作者：
WALSH, PC
前列腺癌的组织学分级（格里森）评估：最高分级的不利影响
DOI：
10.1002/pros.2990040202
发表时间：
1983
期刊：
The Prostate
影响因子：
--
作者：
D. McGowan;G. O. Bain;J. Hanson
通讯作者：
J. Hanson