Prostat İğne Biyopsisi Ve Radikal Prostatektomi Materyallerinde Gleason Skorlarının Karşılaştırılması

Year 2013, Volume: 20 Issue: 3, 93 - 98, 30.09.2013

Kemal Bozkurt , Mustafa Kızmaz Gülsün İnan Mamak İsmail Korkmaz Sema Bircan

Abstract

AMAÇ: Gleason skoru (GS) prostat kanserinde önemli bir prognostik belirteç olup evre ve prognozla kuvvetli korelasyon göstermektedir. Ancak prostat iğne biyopsilerine (İB) ve radikal prostatektomi (RP) materyallerine verilen skorlar her zaman uyum göstermemektedir. Çalışmamızda İB ve RP'lere verilen GS'lerin tanısal uyumluluğu araştırılacaktır.
GEREÇ VE YÖNTEM: Çalışmaya prostat İB'de adenokarsinom tanısı alarak RP operasyonu geçirmiş 51 hasta alındı. Her iki materyale verilen GS'ler karşılaştırılarak verilen skorların tanısal uyumluluğu araştırıldı. Ayrıca olgulara ait serum prostat spesifik antijen (PSA) seviyeleri ile biyopside tümör içeren kadran sayısının tanısal uyuma etkisi incelendi.
BULGULAR: Prostat iğne biyopsisi GS'leri sırasıyla 43 (%84,3) olguda 6, 7 (%13,7) olguda 7 ve 1 (%2) olguda 9 idi. Elli bir olgunun 35'inde (%68,6) İB ve RP GS'lerinde tam uyum vardı. İğne biyopsisinde GS 6'ya sahip 43 olgunun 28'inde (%65,1) ve GS 7'ye sahip 7 olgunun tamamında (%100) RP materyaliyle tam uyum vardı. Bu oranlar GS 6 ve 7'nin pozitif prediktif değerleriydi. On beş (%29,4) olgunun İB materyalinde GS, RP materyalinin skorundan düşükken, 1 (%2) olguda daha yüksek verilmişti. Prostat İB'lerinde tümör pozitif kadran sayısının ve serum PSA seviyesinin GS uyumluluğunu anlamlı etkilemediği saptandı (p>0,05).
SONUÇ: Gleason skorlama sistemi prostat kanserinde tedavi ve prognozu belirlemede önemli bir parametredir. Bu nedenle İB'de verilen GS'nin RP materyalindeki GS ile uyumun sağlanması tedaviyi belirlemede önemlidir.
Anahtar Kelimeler: Prostat, Adenokarsinom, Gleason Skoru

COMPARISON OF THE GLEASON SCORES OF PROSTATE NEEDLE BIOPSIES AND RADICAL PROSTATECTOMY SPECIMENS

ABSTRACT
AIM: Gleason score (GS) is an important prognostic marker for prostate cancer and it is strongly correlated with stage and prognosis. However, needle biopsy (NB) GS is not always consistent with that of radical prostatectomy (RP) specimens. In this study, the correlation of GSs of NB and RP specimens will be examined.
MATERIALS AND METHODS: Study population comprised of 51 patients who had diagnosed as adenocarcinoma by prostate NB and underwent RP operation. The GSs of both specimens were compared and their correlation was investigated. In addition, the effect of blood prostate-specific antigen (PSA) levels and number of tumor positive quadrants in NBs on the correlation was also examined.
RESULTS: Gleason scores of NBs were 6, 7 and 9 in 43 (84.3%), 7 (13.7%) and 1 (2%) patients respectively. Exact correlation existed between GSs of NB and RP specimens for 35 (68.6%) cases. Positive predictive values for biopsy GSs 6 and 7 were 65.1% and 100%, respectively. Fifteen (29.4%) biopsies were undergraded and 1 (2%) was overgraded. Blood PSA levels and number of tumor positive quadrants in prostate NBs did not affect GS correlation (p>0.05).
CONCLUSION: Gleason scoring system is an important parameter on determining the treatment and prognosis in prostate cancer. Thereby, it is important to provide a correlation between GSs of prostate NBs and RP specimens for the treatment.
Key Words: Prostate, Adenocarcinoma, Gleason Score

Keywords

Prostat, Adenokarsinom, Gleason Skoru

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