Concordance between Gleason scores of needle biopsies and radical prostatectomy specimens: a population-based study
Concordance between Gleason scores of needle biopsies and radical prostatectomy specimens: a population-based study
复制标题
DOI：
10.1111/j.1464-410x.2008.08255.x
复制
发表时间：
2009-06-01
影响因子：
4.5
通讯作者：
Halvorsen, Ole J.
中科院分区：
文献类型：
--
作者：
Kvale, Rune;Moller, Bjorn;Halvorsen, Ole J.
研究基于人群登记的针活检和根治性前列腺切除术（RP）标本的Gleason评分之间的一致性，以澄清一致性是否取决于病理单元评估的RP标本的年度数量，并确定术前临床因素，预测RP标本的Gleason评分从= 7升级。通过挪威癌症登记处，我们从活检和RP标本中确定了1116例具有可用Gleason评分的患者。使用kappa系数评估一致性，并通过单变量和多变量逻辑回归分析评估一致性的预测因子。1116例患者中有591例（53%）活检和RP标本的Gleason评分相同。与基于活组织检查的Gleason评分相比，基于rp的Gleason评分低分级（38%）多于高分级（9%）。每年检查40个RP标本的病理单位在活检和RP标本中的Gleason评分之间的一致性高于低容量单位。RP标本的Gleason评分为= 7，随着术前前列腺特异性抗原血清水平的增加以及活检和RP之间间隔的增加，RP标本的升级率也随之增加。在定期评估RP标本的病理科室中，活检与RP之间Gleason评分的一致性最高。仔细考虑临床因素和活检分级可能会提高对被认为适合主动监测的患者的识别。
To study the concordance between the Gleason scores of needle biopsies and radical prostatectomy (RP) specimens in a population-based registry, to clarify whether the concordance depends on the annual number of RP specimens assessed in the pathology unit, and to identify preoperative clinical factors that predict upgrading from a Gleason score of = 7 in the RP specimen.Through the Cancer Registry of Norway, we identified 1116 patients with available Gleason scores from biopsy and RP specimens. Concordance was evaluated using the kappa coefficient, and predictors of concordance were assessed in univariate and multivariate logistic regression analyses.The Gleason scores were identical in biopsy and RP specimens in 591 of the 1116 (53%) patients. The biopsy-based Gleason score more often under-graded (38%) than over-graded (9%) the RP-based Gleason score. Pathology units that examined > 40 RP specimens annually had a higher concordance between the Gleason score in the biopsy and RP specimen than did lower-volume units. The rate of upgrading from a Gleason score of = 7 in the RP specimen increased with increasing preoperative prostate-specific antigen serum levels, and with increasing intervals between biopsy and RP.The concordance in Gleason score between biopsy and RP was highest among the pathology departments that regularly evaluated RP specimens. Careful consideration of clinical factors and biopsy grading might improve the identification of patients considered as suitable for active surveillance.