临床病理学实践中前列腺癌Gleason评分变化趋势

The changing trend of prostate carcinoma Gleason score in clinicopathological practice

目的:研究临床病理学实践中前列腺癌Gleason评分(GS)变化趋势。方法:系统研究不同时期911例前列腺癌GS、主要分级以及次要分级均值和比例。比较穿刺活检(NB)、经尿道前列腺切除(TURP)以及根治性前列腺切除(RP)标本的差异。结果:1995-2005年前列腺癌GS(6.86±1.12)分,2006-2013年GS(7.06±1.09)分,GS均值显著提高(t=-2.428,P<0.05)。在TURP中GS分别是(6.46±1.38)分和(7.14±1.32)分,GS均值显著提高(t=-2.132,P<0.05)。GS≤5分分别占4.7%(11/234)和0.4%(3/677),GS≤5分比例显著下降(χ2=20.465,P<0.01)。结论:前列腺癌GS均值具有提高趋势。应该使用ISUP系统进行前列腺癌GS。

Objective： To study the trend of change of prostate carcinoma Gleason score （GS） in clinicopathologi- cal practice. Methods：We systematically studied 911 prostate carcinoma in different period, and evaluated the mean level and proportion of GS, primary grading and secondary grading, and compared the difference between needle biop- sy,transurethral resection of prostate and radical prostatectomy. Results：The mean level of GS was （6.86 ± 1.12 ） point in prostate carcinoma in 1995 to 2005 year,and was （7.06 ±1.09） point in 2006 -2013 year. The mean GS significantly increased （ t = - 2.428,P 〈 0.05 ）. This indicator in TURP were （ 6.46 ± 1.3 8 ） point and （7.14 ± 1.32 ） point, respectively. The mean GS significantly increased （ t = - 2.132, P 〈 0.05 ）. The proportion of GS ≤ 5 was 4.7 % （ 11/234 ） and 0.4% （ 3/677 ）, respectively. The rate of GS ≤ 5 significantly decreased （ χ^2 = 20.465, P 〈 0.01 ）. Conclusion：There is an increasing trend in mean Gleason score of prostate carcinoma. ISUP system should be used for prostate carcinoma GS.