Research Article
PROSTAT ADENOKARSİNOMLARINDA İĞNE BİYOPSİLERİ İLE RADİKAL PROSTATEKTOMİ MATERYALLERİ ARASINDAKİ GLEASON SKOR UYUMSUZLUĞU
Abstract
Prostat kanseri
erkeklerdeki en sık kanserdir. Gleason skorlaması (GS), transrektal ya da
transperitoneal yoldan alınan biyopsi materyallerindeki glandüler yapıların
diferansiyasyon derecesinin 1 ile 5 arasında puanlandırılması ile elde edilen
sistemdir. Transrektal iğne biyopsisi ve
radikal prostatektomi spesmeni arasındaki GS uyumu önemlidir ve pek çok
çalışmada bu uyumun düşük olduğu gösterilmiştir. Bu çalışmada kiniğimizde yapılan
TRUS biyopsiler sonucunda Prostat adenokarsinom
(PCA) tanısı alan hastaların retropubik radikal prostatektomi (RRP)
sonrası GS arasındaki uyum değerlendirilmiştir.
MATERYEL VE METOD: SDÜ
Üroloji Kliniği‘nde 2015 -2018 yılları arasında PSA yüksekliği (>2.5 ng/ml)
veya anormal dijital rektal muayene bulguları olan, sonrasında RRP yapılmış 182
hastanın patoloji sonuçları retrospektif olarak değerlendirildi.
BULGULAR: 12 kor TRUS biyopsi
yapılan ve prostat kanseri tanısı konulup RRP yapılan 182 hastanın kayıtları
retrospektif olarak değerlendirildi. Hastaların ortanca yaşı 67 (49-85) yıl,
preoperatif total PSA median değeri 8.28 ng/ml (2,6-40,43) olarak saptandı. Hastaların ortalama
prostat hacimleri 70 cc (40-130 cc ) olarak değerlendirildi. Biyopsi sonrası
elde edilen GS ile RP sonrası patolojik spesmen GS arasındaki uyuma
bakıldığında 100 (%54,6) hastanın preoperatif belirlenen GS skoru ile RRP
skorunun aynı olduğu gözlenmiştir.
SONUÇ:
TRUS biyopsi ile RP GS arasındaki uyum sorunu devam etmektedir. Her ne
kadar verilerimiz literatür ile uyumlu olsa da alternatif biyopsi değerlendirme
yöntemlerine ihtiyacımız olduğu görülmüştür.
Keywords
References
- 1.Hanno P, Malkowicz SB and Wein AJ (eds): Clinical Manual of Urology. 3rd edition. McGraw Hill, New York, NY, pp 519, 2001. 2 .Guidelines on Prostat cancer, Epidemiology, Aetiology and Patology. EAU Guidelines 2016 3. Bostwick DG. Grading prostate cancer. Am J Clin Pathol 1994; 102: 38-56. 4. Epstein JI, Partin AW, Sauvageot J, Walsh PC. Prediction of progression following radical prostatectomy. A multivariate analysis of 721 men with long-term followup. Am J Surg Pathol 1996;20:286-92 5. Moussa AS, Li J, Soriano M, Klein EA, Dong F, Jones JS. Prostate biopsy clinical and pathological variables that predict significant grading changes in patients with intermediate and high grade prostate cancer. BJU Int 2009;103:43-8. 6. King CR. Patterns of prostate cancer biopsy grading: Trends and clinical implications. IJC 2000; 90(6):305-11. 7. Epstein JI, Zelefsky MJ, Sjoberg DD, et al. A contemporary prostate cancer grading system: a validated alternative to the Gleason score. Eur Urol 2016; 69: 428. 8. Altay B, Kefi A, Nazli O, Killi R, Semerci B, Akar I. Comparison of Gleason scores from sextant prostate biopsies and radical prostatectomy specimens. Urol Int 2001;67:14-8. 9. Carlson GD, Calvanese CB, Kahane H, Epstein JI. Accuracy of biopsy Gleason scores from A large uropathology laboratory: use of a diagnostic protocol to minimize observer variability. Urology 1998;51:525-9. 10. Patel AR, Jones JS. Optimal biopsy strategies for the diagnosis and staging of prostate cancer. Curr Opin Urol 2009; 19: 232-7. 11. Dong F, Jones JS, Stephenson AJ, Magi-Galluzzi C, Reuther AM, Klein EA. Prostate cancer volume at biopsy predicts clinically significant upgrading. J Urol 2008; 179: 896- 900 12. Amin MB, Grignon DJ, Humphery PA, SrigleyJR. Gleason grading of prostate cancer. Philadelphia: Lippincott Williams & Wilkins; 2004. 13. Humphrey PA. Prostate pathology. Chicago: ASCP Press; 2003. 14. Sarici H, Telli O, Yigitbasi O, et al. Predictors of Gleason score upgrading in patients With prostate biopsy Gleason score ≤6. Can Urol Assoc J 2014; 8: E342-6. 15. Epstein JI, Feng Z, Trock BJ, Pierorazio PM. Upgrading and downgrading of prostate cancer from biopsy to radical prostatectomy: Incidence and predictive factors using modified Gleason grading system and factoring in tertiary grades. Eur Urol 2012;61:1019-24. 16. Wolff JM, Boeckmann W, Mattelaer P, Handt S, Adam G, Jakse G. Determination of prostate gland volume by transrectal ultrasound: correlation with radical prostatectomy specimens. Eur Urol 1995;28:10-2. 17. Sved PD, Gomez P, Manoharan M, Kim SS, Soloway MS. Limitations of biopsy Gleason grade: implications for counseling patients with biopsy Gleason score 6prostate cancer. J Urol 2004;172:98-102. 18. Fukagai T, Namiki T, Namiki H, Carlile RG, Shimada M,Yoshida H. Discrepancies between Gleason scores of needle biopsy and radical prostatectomy specimens. Pathol Int 2001;51:36 - 70 19. Gleason DF. Histologic grading of prostate cancer: a perspective. Hum Pathol 1992; 23(3):273–79. 20. Divrik RT, Eroğlu, A, Şahin A, ZorluF, Özen H. Increasing the number of biopsies increases the concordance of Gleason scores of needle biopsies and prostatectomy specimens. Eur Urol 2007; 25(5):376-82. 21. Turley RS, Hamilton RJ, Terris MK et al. Small transrectal ultrasound volume predicts clinically significant Gleason score upgrading after radical prostatectomy: results from the SEARCH database. J Urol 2008; 179: 523– 527. 22. Rosenkrantz, A. B., & Taneja, S. S. (2015). Prostate MRI Can Reduce Overdiagnosis And Overtreatment of Prostate Cancer. Academic Radiology,
Year 2020,
, 477 - 481, 25.12.2020
Abstract
References
- 1.Hanno P, Malkowicz SB and Wein AJ (eds): Clinical Manual of Urology. 3rd edition. McGraw Hill, New York, NY, pp 519, 2001. 2 .Guidelines on Prostat cancer, Epidemiology, Aetiology and Patology. EAU Guidelines 2016 3. Bostwick DG. Grading prostate cancer. Am J Clin Pathol 1994; 102: 38-56. 4. Epstein JI, Partin AW, Sauvageot J, Walsh PC. Prediction of progression following radical prostatectomy. A multivariate analysis of 721 men with long-term followup. Am J Surg Pathol 1996;20:286-92 5. Moussa AS, Li J, Soriano M, Klein EA, Dong F, Jones JS. Prostate biopsy clinical and pathological variables that predict significant grading changes in patients with intermediate and high grade prostate cancer. BJU Int 2009;103:43-8. 6. King CR. Patterns of prostate cancer biopsy grading: Trends and clinical implications. IJC 2000; 90(6):305-11. 7. Epstein JI, Zelefsky MJ, Sjoberg DD, et al. A contemporary prostate cancer grading system: a validated alternative to the Gleason score. Eur Urol 2016; 69: 428. 8. Altay B, Kefi A, Nazli O, Killi R, Semerci B, Akar I. Comparison of Gleason scores from sextant prostate biopsies and radical prostatectomy specimens. Urol Int 2001;67:14-8. 9. Carlson GD, Calvanese CB, Kahane H, Epstein JI. Accuracy of biopsy Gleason scores from A large uropathology laboratory: use of a diagnostic protocol to minimize observer variability. Urology 1998;51:525-9. 10. Patel AR, Jones JS. Optimal biopsy strategies for the diagnosis and staging of prostate cancer. Curr Opin Urol 2009; 19: 232-7. 11. Dong F, Jones JS, Stephenson AJ, Magi-Galluzzi C, Reuther AM, Klein EA. Prostate cancer volume at biopsy predicts clinically significant upgrading. J Urol 2008; 179: 896- 900 12. Amin MB, Grignon DJ, Humphery PA, SrigleyJR. Gleason grading of prostate cancer. Philadelphia: Lippincott Williams & Wilkins; 2004. 13. Humphrey PA. Prostate pathology. Chicago: ASCP Press; 2003. 14. Sarici H, Telli O, Yigitbasi O, et al. Predictors of Gleason score upgrading in patients With prostate biopsy Gleason score ≤6. Can Urol Assoc J 2014; 8: E342-6. 15. Epstein JI, Feng Z, Trock BJ, Pierorazio PM. Upgrading and downgrading of prostate cancer from biopsy to radical prostatectomy: Incidence and predictive factors using modified Gleason grading system and factoring in tertiary grades. Eur Urol 2012;61:1019-24. 16. Wolff JM, Boeckmann W, Mattelaer P, Handt S, Adam G, Jakse G. Determination of prostate gland volume by transrectal ultrasound: correlation with radical prostatectomy specimens. Eur Urol 1995;28:10-2. 17. Sved PD, Gomez P, Manoharan M, Kim SS, Soloway MS. Limitations of biopsy Gleason grade: implications for counseling patients with biopsy Gleason score 6prostate cancer. J Urol 2004;172:98-102. 18. Fukagai T, Namiki T, Namiki H, Carlile RG, Shimada M,Yoshida H. Discrepancies between Gleason scores of needle biopsy and radical prostatectomy specimens. Pathol Int 2001;51:36 - 70 19. Gleason DF. Histologic grading of prostate cancer: a perspective. Hum Pathol 1992; 23(3):273–79. 20. Divrik RT, Eroğlu, A, Şahin A, ZorluF, Özen H. Increasing the number of biopsies increases the concordance of Gleason scores of needle biopsies and prostatectomy specimens. Eur Urol 2007; 25(5):376-82. 21. Turley RS, Hamilton RJ, Terris MK et al. Small transrectal ultrasound volume predicts clinically significant Gleason score upgrading after radical prostatectomy: results from the SEARCH database. J Urol 2008; 179: 523– 527. 22. Rosenkrantz, A. B., & Taneja, S. S. (2015). Prostate MRI Can Reduce Overdiagnosis And Overtreatment of Prostate Cancer. Academic Radiology,
There are 1 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Surgery |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | December 25, 2020 |
| Submission Date | June 29, 2019 |
| Acceptance Date | December 1, 2019 |
| Published in Issue | Year 2020 |
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/Medical Journal of Süleyman Demirel University is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International.