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目的为进一步分析根治性前列腺癌标本处理大切片与常规切片两种方法在病理评分上有无差异,从而评价大切片技术在术后前列腺癌中的诊断价值。方法选取2012年9月至2015年7月在复旦大学附属肿瘤医院行前列腺癌根治术共635例患者的临床资料。其中327例术后行普通病理制片,308例使用大切片技术处理标本。回顾性地收集患者临床资料,包括:患者确诊时年龄、身高、体重、术前PSA水平、术前确诊方式、术前穿刺诊断和Gleason评分、术后病理诊断和术后病理评分。结果比较常规切片组和大切片组患者在手术年龄,BMI,术前PSA值,前列腺癌穿刺确诊时Gleason评分、RP术后病理Gleason评分,差异均无统计学意义(P>0.05)。但将患者的术后病理诊断按最新5级评分系统(2015 Gleason Grade Groups,GGG)进行分层,两组间出现了明显的差异,显示大切片技术可以更多地检出GS 4+3的患者。同时大切片组术后GS相较穿刺GS升高的比例更大(31.5%vs 23.3%),Logistic回归分析发现,大切片组与Gleason升高相关。结论前列腺癌多灶性的特点使得大切片技术相对传统病理切片存在明显优势,值得推广。
Objective To further analyze whether there is any difference in the pathological score between the two methods for the treatment of radical prostate cancer specimens and the conventional slices so as to evaluate the diagnostic value of the large slice technique in postoperative prostate cancer. Methods The clinical data of 635 patients undergoing radical prostatectomy at Affiliated Tumor Hospital of Fudan University from September 2012 to July 2015 were selected. Among them, 327 cases were performed routine pathology and 308 cases were treated with large slice technique. The clinical data of patients were retrospectively collected. The patients’ age, height, weight, preoperative PSA level, preoperative diagnosis, preoperative puncture diagnosis and Gleason score, postoperative pathological diagnosis and postoperative pathological score were collected retrospectively. Results There was no significant difference in the age, BMI, preoperative PSA, Gleason score at diagnosis of prostate cancer and Gleason score at postoperative pathology between the conventional slice group and the large slice group (P> 0.05). However, postoperative pathological diagnosis of the patients was stratified by the 2015 Gleason Grade Groups (GGG) system. There was a significant difference between the two groups, indicating that the large slice technique can detect more GS 4 + 3 patient. At the same time, GS in the large slice group was higher than that in the puncture GS (31.5% vs 23.3%). Logistic regression analysis showed that the large slice group was associated with the elevation of Gleason. Conclusion The multi-foci of prostate cancer make the large-slice technique have obvious advantages over the traditional pathological section and worth promoting.