Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması

Tayfun Şahinkanat; Faruk Küçükdurmaz; Erkan Efe; Eyüp Koluş; Hasan Çetin Ekerbiçer; Muharrem Bitiren

doi:10.17517/ksutfd.205510

TR EN

Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması

Öz

Amaç: Prostat biyopsisiile elde edilen Gleason skoru (GS)lokalize prostat kanseri olgularının tedavi kararında önem taşıdığı için radikal prostatektomi (RP)GSile uyumuoldukça önemlidir. Ancak literatürde bu uyum %24-50 arasında bildirilmektedir. Çalışmamızda kliniğimizde yapılan prostat biyopsileri ile RP sonrası elde edilen patolojik bulguların uyumu değerlendirilmiştir.

Gereç ve Yöntemler: KSÜ Tıp Fakültesi Üroloji Kliniği'nde standart 12 kor transrektalbiyopsi ile prostat kanseri tanısı konan ve sonraki sekiz haftada RP yapılan 24 hastanın patoloji sonuçları retrospektif olarak değerlendirildi. Biyopsilerde GS, kanserli kor sayısı,kanserli korlardaki kanser yüzdesi değerlendirildi. Ayrıca yaş,prostat hacmi,PSA değerlerininbiyopsi ve RP GS’ları arasındaki uyuma etkisi araştırıldı. GS artışı ya da azalışı bir prognostik gruptan diğerine geçiş olarak tanımlandı.Prognostik gruplar GS 6; 7 ve 8≤ olarak kategorize edildi.

Bulgular: Hastaların ortanca yaşı 68 (58-79) yıl,ortanca PSA değeri 9,65 ng/ml (4.2-149) ve prostat hacmi 46.5 ml'ydi (27-70). Tüm hastalar değerlendirildiğinde yalnızca bir olguda (%4.2) GS düşüşü saptandı. Biyopsisinde GS=6 olan olguların %43.5'sinde (n:7/16) RP GS’unda artışısaptanırken, GS=7 olan 7 hastanın ise sadece birinde GS artışı izlendi. GS=8 olan bir hastanın RP GS biyopsi GS’u ile aynıydı. Prostat biyopsi ve patolojik GS arasındaki genel uyum %62.5ve kappa değeri 0,31(p:0,025) idi. GS artışı ile ileri yaş arasında k:0.47 (p=0.01),PSA> 9 olan 14 vaka için k:0.50 (p=0.021) ve prostat hacmi ≥30 cc olan olgularda k:0.42 (p=0.014) olarak bulundu.

Sonuç: Çalışmamızda iğne biyopsi GS ile RP GS arasındaki uyum oranı literatürle uyumlu bulunmakla birlikte, verilerimiz biyopsi ile daha doğru derecelendirme için yeni teknik yaklaşımlara yönelmemiz gerektiğini düşündürtmektedir.

Anahtar kelimeler: biyopsi, prostat kanseri, Gleason skoru, radikal prostatektomi

Anahtar Kelimeler

Biyopsi,prostat kanseri,Gleason skoru,radikal prostatektomi

Comparison Between Needle Biopsy and Radical Prostatectomy Samples in Assessing Gleason Score in Prostatic Adenocarcinomas

Abstract

Objective: Prostate biopsy Gleason score is important for treatment planning in patients with localized prostate cancer. Therefore, concordance between biopsy and radical prostatectomy (RP) pathologies is critically important. However, discordance rates between those two was reported as 24-50% in the literature. Aim of present study is to evaluate concordance rates between biopsy and RP results.

Material and Methods: A retrospective review of 24 patients, who underwent prostate biopsy (standart 12 cores) due to elevated PSA or abnormal digital rectal examination and diagnosed with localised prostate cancer was performed. All patients underwent radical prostatectomy within 8 weeks after biopsy. Associations between preoperative clinical factors and Gleason score upgrading were analyzed. Those factors include Gleason scores, percentage of positive cores, age, prostate volume and PSA value. Gleason upgrading or downgrading was defined as an increase or decrease from one prognostic group to another. Prognostic groups were categorised as GS 6; 7 and 8≤.

Results: Median age of patients was68 (58–79) years and median PSA was 9,65 ng/ml (4.2–149). Median prostate volume was 46,5 ml (27–70). Overall, needle biopsies were under-graded in 1 (4.2%) cases, overgraded in 8 (33.3%), and correctly graded in 15 (62.5%) patients. While upgrading was identified in 7 out of 16 (43,5%) patients with GS 6 on needle biopsy, only one patient with GS=7 on biopsy was upgraded. Overall concordance between biopsy and pathological GS was 62.5% (p = 0.025) and k value was 0.31. Independent predictors of upgrading were age (k:0.47 [p=0.01]), PSA> 9 (k:0.50 [p=0.021]) and prostate volume ≥30 cc (k:0.42 [p=0.014]).

Conclusion: Although our results were consistent with the literature, new approachs are required to better grading with biopsy.

Keywords

Biopsy,prostate cancer,Gleason score,radical prostatectomy

Kaynakça

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Ayrıntılar

Birincil Dil

Türkçe

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

Tayfun Şahinkanat
KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÜROLOJİ ANABİLİM DALI

Faruk Küçükdurmaz
KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÜROLOJİ ANABİLİM DALI

Erkan Efe
KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÜROLOJİ ANABİLİM DALI

Eyüp Koluş Bu kişi benim
KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, ÜROLOJİ ANABİLİM DALI

Hasan Çetin Ekerbiçer
SAKARYA ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ, HALK SAĞLIĞI ANABİLİM DALI

Muharrem Bitiren Bu kişi benim
KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNİVERSİTESİ, TIP FAKÜLTESİ, CERRAHİ TIP BİLİMLERİ BÖLÜMÜ, PATOLOJİ ANABİLİM DALI

Yayımlanma Tarihi

24 Nisan 2017

Gönderilme Tarihi

10 Mart 2016

Kabul Tarihi

13 Nisan 2016

Yayımlandığı Sayı

Yıl 1970 Cilt: 12 Sayı: 1

DOI

https://doi.org/10.17517/ksutfd.205510

IZ

https://izlik.org/JA52HH32ER

AMA

1.Şahinkanat T, Küçükdurmaz F, Efe E, Koluş E, Ekerbiçer HÇ, Bitiren M. Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması. KSÜ Tıp Fak Der. 2017;12(1):25-30. doi:10.17517/ksutfd.205510

Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması

Öz

Anahtar Kelimeler

Comparison Between Needle Biopsy and Radical Prostatectomy Samples in Assessing Gleason Score in Prostatic Adenocarcinomas

Abstract

Keywords

Kaynakça

Ayrıntılar

Birincil Dil

Konular

Bölüm

Yazarlar

Yayımlanma Tarihi

Gönderilme Tarihi

Kabul Tarihi

Yayımlandığı Sayı

DOI

IZ

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