Analysis Of Influencing Factors Of Gleason Grade Upgrading After Radical Prostatectomy(Based On 2014 ISUP Grouping)

Objective:To study and analyze the factors influencing the upgrade of Gleason score after radical resection of prostate cancer on the basis of ISUP grouping in 2014 edition.Methods:The clinical data of 189 patients who underwent laparoscopic radical resection of prostate cancer in the First Affiliated Hospital of Xinjiang Medical University from January 2016 to December 2021 were collected.Among them,age(66.09±6.73 years),body mass index(BMI)(25.26±3.22kg/m2),time from prostate puncture to RP(32 days,21～57days).According to age,body mass index,prostate volume,neutrophil count,lymphocyte count,NLR,triglyceride,cholesterol,TPSA,FPSA,time from puncture to surgery,positive rate of puncture,symptoms of prostatic hyperplasia,history of hypertension,history of diabetes,history of smoking,history of preoperative endocrine therapy,puncture nerve invasion,length of puncture tumor tissue,and puncture owner Regional score,puncture secondary area score and PI-RADS score were grouped,and the differences in pathological Gleason score before and after radical resection of prostate cancer were compared on the basis of the 2014 version of ISUP grouping.t test,χ~2 test and rank sum test were used for univariate analysis,and multiple Logistic regression analysis was performed.To evaluate and analyze the factors influencing Gleason score upgrading after radical resection of prostate cancer.Results:In this study,there were 60 cases in the Gleason Grade Upgrading group(GGU group)and 129 cases in the Gleason Grade non-upgraded group(non-GGU group).In the non-GGU group,GS remained unchanged after RP in 98 cases(51.85%),and decreased after RP in 31 cases(16.40%).During puncture,ISUP groups were 1-4.The rates of prostate cancer upgrading after radical resection were 46.30%,50.00%,36.36%and15.00%,respectively.Univariate analysis showed that puncture tumor tissue length(P=0.015),Gleason primary zone score(P<0.001)and Gleason secondary zone score(P=0.005)were correlated with GGU.After multivariate Logistic regression,hypertension history(P=0.012,OR=2.662),major Gleason scores(P<0.001,OR=8.471),tumor tissue length(P=0.006,OR=3.971)and positive rate(P=0.012,OR=2.998)is related to GGUs.Conclusion:History of hypertension,Gleason score,tumor tissue length and positive rate may be related to the risk of GGU.History of hypertension,longer tumor tissue length,lower Gleason score and higher positive rate were more likely to increase the incidence of GGU.