To Comepare The Concordance Rate In Gleason Score Between Needle Biopsy And Prostatectomy Specimens In Prostate Cancer And An Analysis Of Correlative Influence Factors

Objective:As the prostate cancer is one of the most common malignant tumor in elderly men, the Gleason score of prostate cancer is one of the most important references for preoperative judgement of prognosis and making treatment decisions.While needle biopsy Gleason scores is not consistent with the pathological examination of the patients after prostatectomy usually. This study was aimed to evaluate the concordance in Gleason scores between prostate needle biopsy and prostatectomy specimens and to analyze whether age, the serum prostate specific antigen (PSA) and situations of metastasis were the possible factors affecting the accuracy of biopsy Gleason scores.Materials and Methods:A retrospective analysis the medical records of 46 prostate cancer patients who were diagnosed by pathological examination at our hospital from 2011 January to 2015 December period to analyze the difference between the two kinds of scores and to figure out the correlative influence factors of age, PSA and situations of metastasis on the concordance. All the objects were in the prostate biopsy or surgical operation after the determination of serum PSA. Routine pathological examination was very necessary to prostate specimens as well as pathological grade of tumor tissue. According to the clinical comprehensive diagnosis results, combined with the situations of metastasis. Statistical analysis was conducted on the data that we obtained in this study, using P<0.05 as the difference had statistical significance.Results:1. Compared to the Gleason score of biopsy specimens, that of prostatectomy specimens was concordant in 25(54.3%), lower in 6(13.1%), and higher in 15(32.6%) patients, the difference had statistical significance(P<0.05);2. The PSA level was an influence factor to the concordance rate between needle biopsy Gleason score and prostatectomy Gleason score, the difference had statistical significance(P<0.05);3. Nether age nor situations of metastasis were the influence factors to the concordance rate between needle biopsy Gleason score and prostatectomy Gleason score, the difference had no statistical significance(P<0.05).Conclusion:1. There were some difference between needle biopsy Gleason score and prostatectomy Gleason score, and lower biopsy score(GS<6) had a big difference on the concordance of them;2. The PSA level was an important factor affecting the concordance rate between needle biopsy Gleason score and prostatectomy Gleason score, while age and situations of metastasis were not;3. Take more careful of the patients whose needle biopsy GS≤6 and PSA ranges from 0 to 4 ng/ml, combined other indexes for preoperative judgement of prognosis and then made the best treatment decisions when it was necessary.