Factors predicting 2014 ISUP pathology grade upgrading from prostate biopsy to radical prostatectomy pathology

Q4 Medicine

中华泌尿外科杂志 Pub Date : 2020-02-15 DOI:10.3760/CMA.J.ISSN.1000-6702.2020.02.007

Y. Ouyang, Dong-Han Chen, Yonghong Li, Zhiyong Li, Y. Ye, Zhiming Wu, Li-juan Jiang, Yijun Zhang, Zhiling Zhang, Yun Cao, F. Zhou

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引用次数: 0

Abstract

Objective To investigate the risk factors predicting pathology grade upgrading after radical prostatectomy using the 2014 International Society of Urologic Pathology (ISUP) grading system. Methods A total of 205 patients who underwent biopsy and radical prostatectomy from January 2017 to December 2018 were reviewed retrospectively. The median and range of the patients’age, PSA level, prostate volume, number of biopsy core examined, Gleason score and ISUP grade were 66(45-81)years old, 17.16(0.89-1254.00)ng/ml, 36.4(4.1-152.1)ml, 10(1-15), 7(6-10), and 3(1-5) respectively. The patients were divided into group of upgrading ISUP grade and group without upgrading ISUP grade. Multivariate Logistic regression analysis and receiving operating characteristic curve analysis were performed to identify predictors of ISUP upgrading and determine the optimal cut off value respectively. Result The median and range of Gleason score and ISUP grade after radical prostatectomy were 7(6-10), and 3(1-5) respectively. The radical prostatectomy ISUP grade upgraded in 73(35.6%)out of 205 cases when compared with biopsy ISUP grade. Radical prostatectomy ISUP grades were concordant in 91 cases (44.4%) and downgraded in 41 cases(20.0%). Of 101 with biopsy ISUP grades less than or equal to 2, the ISUP grade of radical prostatectomy upgraded in 58 cases(57.4%), while radical prostatectomy ISUP grade upgraded in only 18(26.9%) of 67 patients with biopsy ISUP grades of 3 or 4. Biopsy ISUP grades represent an independent predictor for ISUP grade upgrading after radical prostatectomy(OR=0.496, P<0.001). Conclusion Patients with biopsy ISUP grades less than or equal to 2 are at great risk of ISUP grade upgrading after radical prostatectomy. Key words: Prostatic neoplasms; Prostate cancer; Radical prostatectomy; Biopsy; Pathology upgrading

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预测2014年ISUP病理分级从前列腺活检升级为根治性前列腺切除术病理的因素

目的利用2014年国际泌尿病理学会（ISUP）分级系统，探讨预测前列腺根治术后病理分级升级的危险因素。方法回顾性分析2017年1月至2018年12月接受活检和前列腺根治术的205例患者。患者年龄、PSA水平、前列腺体积、活检芯数、Gleason评分和ISUP分级的中位数和范围分别为66（45-81）岁、17.16（0.89-1254.00）ng/ml、36.4（4.1-152.1）ml、10（1-15）、7（6-10）和3（1-5）。将患者分为ISUP分级升级组和ISUP分级未升级组。分别进行多元Logistic回归分析和接收操作特征曲线分析，以确定ISUP升级的预测因素并确定最佳截止值。结果前列腺癌根治术后Gleason评分和ISUP评分的中位数和范围分别为7（6-10）和3（1-5）。与活检ISUP分级相比，205例患者中有73例（35.6%）的根治性前列腺切除术ISUP分级提高。91例（44.4%）根治性前列腺切除术的ISUP分级一致，41例（20.0%）降级。在101例活检ISUP分级小于或等于2的患者中，58例（57.4%）的根治性前列腺摘除术的ISUP分级升级，而67例活检ISUP分级为3或4的患者中只有18例（26.9%）的前列腺切除术ISUP分级升级。活检ISUP分级是根治性前列腺切除术后ISUP分级升级的独立预测指标（OR=0.496，P<0.001）。关键词：前列腺肿瘤；前列腺癌症；根治性前列腺切除术；活检；病理学升级

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来源期刊

中华泌尿外科杂志 Medicine-Nephrology

CiteScore

0.10

自引率

0.00%

发文量

14180

期刊介绍： Chinese Journal of Urology (monthly) was founded in 1980. It is a publicly issued academic journal supervised by the China Association for Science and Technology and sponsored by the Chinese Medical Association. It mainly publishes original research papers, reviews and comments in this field. This journal mainly reports on the latest scientific research results and clinical diagnosis and treatment experience in the professional field of urology at home and abroad, as well as basic theoretical research results closely related to clinical practice. The journal has columns such as treatises, abstracts of treatises, experimental studies, case reports, experience exchanges, reviews, reviews, lectures, etc. Chinese Journal of Urology has been included in well-known databases such as Peking University Journal (Chinese Journal of Humanities and Social Sciences), CSCD Chinese Science Citation Database Source Journal (including extended version), and also included in American Chemical Abstracts (CA). The journal has been rated as a quality journal by the Association for Science and Technology and as an excellent journal by the Chinese Medical Association.