Impact on the Clinical Outcome of Prostate Cancer by the 2005 International Society of Urological Pathology Modified Gleason Grading System
Impact on the Clinical Outcome of Prostate Cancer by the 2005 International Society of Urological Pathology Modified Gleason Grading System
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DOI：
10.1097/pas.0b013e3182486faf
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发表时间：
2012-06-01
影响因子：
5.6
通讯作者：
Wu, Chin-Lee
中科院分区：
文献类型：
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作者：
Dong, Fei;Wang, Chaofu;Wu, Chin-Lee
2005年国际泌尿病理学会（ISUP）共识会议修改了前列腺癌的格里森分级系统。在修改后的标准中，定义不清的腺体，管腔形成不良，大筛状腺体，边界光滑，经典描述为格里森3型腺癌，被重新定义为格里森4型。为了评估ISUP标准升级患者的临床结局，回顾了一家机构1240例连续根治性乳腺癌切除术标本的组织学切片，并根据原始和修改后的Gleason标准对每个腺癌病例进行分级。共分析了806例经典Gleason评分3 + 3 = 6或3 + 4 = 7和改良Gleason评分6 - 8的前列腺癌患者，中位总体随访时间为12.6年。在研究人群中，34%的经典Gleason评分3 + 3 = 6的前列腺癌患者根据ISUP标准升级至改良Gleason评分7或8。与改良Gleason评分3 + 3 = 6的患者和经典Gleason评分3 + 4 = 7的患者相比，升级的患者处于生化进展的中等风险（配对对数秩P
The 2005 International Society of Urological Pathology (ISUP) Consensus Conference modified the Gleason grading system for prostate cancer. In the modified criteria, ill-defined glands with poorly formed lumina and large cribriform glands with smooth borders, classically described as Gleason pattern 3 adenocarcinoma, were redefined as Gleason pattern 4. To evaluate the clinical outcome of patients upgraded by the ISUP criteria, the histologic slides of 1240 consecutive radical prostatectomy specimens at a single institution were reviewed, and each case of adenocarcinoma was graded on the basis of the original and modified Gleason criteria. A total of 806 patients with prostate cancer of classical Gleason score 3 + 3 = 6 or 3 + 4 = 7 and modified Gleason score 6 to 8 were analyzed with a median overall follow-up of 12.6 years. In the study population, 34% of patients with classical Gleason score 3 + 3 = 6 prostate cancer were upgraded to modified Gleason score 7 or 8 by the ISUP criteria. Compared to patients with modified Gleason score 3 + 3 = 6 and patients with classical Gleason score 3 + 4 = 7, the upgraded patients were at intermediate risk for biochemical progression (paired log-rank P