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目的:比较超声引导下经直肠前列腺穿刺活检病理组织Gleason评分与前列腺癌根治术后病理Gleason评分的差异。方法:回顾性分析比较青岛市立医院2009年2月~2014年11月间行前列腺癌根治术的66例患者术前10+X穿刺活检Gleason评分、术后Gleason评分及其差异性。结果:66例患者中,高分化癌(Gleason评分2~4分)0例,中分化癌(Gleason评分5~6分)13例(19.7%),低分化癌(Gleason评分7~10分)53例(80.3%);前列腺穿刺标本与根治术后标本Gleason评分符合率为51.5%,评分偏低39.4%,评分偏高9.1%。按前列腺癌分级分组整体评价,Gleason评分符合率分别为3~6分34.5%,7分75.0%,8~9分33.3%。结论:应用穿刺活检Gleason评分指导临床治疗方案和判断预后较为可靠,但临床医生仍需考虑到其局限性。
OBJECTIVE: To compare the difference between the Gleason score of ultrasound-guided pathology of transrectal prostate biopsy and the pathological Gleason score of radical prostatectomy. Methods: The preoperative Gleason score of 10 + X biopsy and postoperative Gleason score of 66 patients with radical prostatectomy from February 2009 to November 2014 in Qingdao Municipal Hospital were retrospectively analyzed. Results: Among 66 patients, 0 cases had well-differentiated carcinoma (Gleason score 2-4), 13 cases (19.7%) with moderately differentiated carcinoma (Gleason score 5-6) and poorly differentiated carcinoma (Gleason score 7-10) 53 cases (80.3%). The coincidence rate of prostatic puncture specimen and Gleason score was 51.5%, the score was 39.4% lower and the score was 9.1% higher. According to the overall rating of the prostate cancer grading, the coincidence rates of Gleason score were 3 to 6 points 34.5%, 7 points 75.0%, 8 to 9 points 33.3%. Conclusions: The use of biopsy Gleason score to guide clinical treatment programs and to determine the prognosis is more reliable, but clinicians still need to consider its limitations.