Prostate cancer grade assignment: The effect of chronological, interpretive and translation bias
Prostate cancer grade assignment: The effect of chronological, interpretive and translation bias
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DOI：
10.1097/01.ju.0000085675.96097.76
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发表时间：
2003-10-01
影响因子：
6.6
通讯作者：
Schellhammer, PF
中科院分区：
文献类型：
--
作者：
Kondylis, FI;Moriarty, RP;Schellhammer, PF
目的：监测、流行病学和最终结果(SEER)数据显示，中分化前列腺癌的发病率呈上升趋势，而高分化和低分化前列腺癌的发病率呈稳定或下降趋势。这一现象的合理原因包括经尿道切除术的减少和前列腺特异性抗原触发的超声引导下的针吸活检的数量的增加。材料和方法：对1975-1985年间收治的100例前列腺癌患者(82例针吸活检标本和18例经尿道电切标本)的档案切片进行了复查。目前的等级是使用WHO和格里森评分系统进行分配的，并与最初的等级分配进行了比较。目前的Gleason评分根据可操作的SEER标准(2至4级、5至7级、8至10级)转换为WHO分级。用寿命表法对100例标本进行分析，根据分级的时代计算癌症的特定生存率。结果：从历史分级到现在的WHO分级，以及从当前的Gleason评分到WHO分级的SEER方法的翻译，有显著的向上转移(p
Purpose: Surveillance, Epidemiology and End Results (SEER) data reveal an increasing incidence in the detection of moderately differentiated prostate cancer and a stable or decreasing incidence in well and poorly differentiated cancer. Plausible reasons for this phenomenon include the decrease in transurethral resections performed and an increase in the number of prostate specific antigen triggered ultrasound guided needle biopsies. We examined additional explanations for the grade shift with time and addresses the impact of this grade shift on clinical end points.Materials and Methods: Archived slides from 100 patients (82 needle biopsy specimens and 18 transurethral resection specimens) treated for prostate cancer between 1975 and 1985 were reexamined. Current grades were assigned using the WHO and the Gleason grading systems, and they were compared with the original grade assignments. Current Gleason score was translated to WHO grade by operational SEER criteria (2 to 4-well, 5 to 7-moderately and 8 to 10-poorly differentiated). Analysis of the 100 specimens by life table methodology calculated cancer specific survival according to the era of grade assignment.Results: There was significant upward grade migration from the historic to the current WHO grade and from the translation by SEER methodology of the current Gleason score to WHO grade (p