Factors predicting 2014 ISUP pathology grade upgrading from prostate biopsy to radical prostatectomy pathology
10.3760/cma.j.issn.1000-6702.2020.02.007
- VernacularTitle:根治性前列腺切除术后ISUP病理分级较前列腺穿刺病理分级升高的预测因素
- Author:
Yi OUYANG
1
;
Dong CHEN
;
Yonghong LI
;
Zhiyong LI
;
Yangtian YE
;
Zhiming WU
;
Lijuan JIANG
;
Yijun ZHANG
;
Zhiling ZHANG
;
Yun CAO
;
Fangjian ZHOU
Author Information
1. 中山大学肿瘤防治中心泌尿外科
- Keywords:
Prostatic neoplasms;
Prostate cancer;
Radical prostatectomy;
Biopsy;
Pathology upgrading
- From:
Chinese Journal of Urology
2020;41(2):114-119
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors predicting pathology grade upgrading after radical prostatectomy using the 2014 International Society of Urologic Pathology (ISUP) grading system.Methods A total of 205 patients who underwent biopsy and radical prostatectomy from January 2017 to December 2018 were reviewed retrospectively.The median and range of the patients' age,PSA level,prostate volume,number of biopsy core examined,Gleason score and ISUP grade were 66 (45-81) years old,17.16(0.89-1254.00)ng/ml,36.4(4.1-152.1) rnl,10(1-15),7(6-10),and 3(1-5) respectively.The patients were divided into group of upgrading ISUP grade and group without upgrading ISUP grade.Multivariate Logistic regression analysis and receiving operating characteristic curve analysis were performed to identify predictors of ISUP upgrading and determine the optimal cut off value respectively.Result The median and range of Gleason score and ISUP grade after radical prostatectomy were 7 (6-10),and 3 (1-5) respectively.The radical prostatectomy ISUP grade upgraded in 73 (35.6％) out of 205 cases when compared with biopsy ISUP grade.Radical prostatectomy ISUP grades were concordant in 91 cases (44.4％) and downgraded in 41 cases(20.0％).Of 101 with biopsy ISUP grades less than or equal to 2,the ISUP grade of radical prostatectomy upgraded in 58 cases (57.4％),while radical prostatectomy ISUP grade upgraded in only 18 (26.9％) of 67 patients with biopsy ISUP grades of 3 or 4.Biopsy ISUP grades represent an independent predictor for ISUP grade upgrading after radical prostatectomy (OR =0.496,P ＜ 0.001).Conclusion Patients with biopsy ISUP grades less than or equal to 2 are at great risk of ISUP grade upgrading after radical prostatectomy.
