不同标本前列腺癌Gleason评分差异分析

目的：探讨不同标本前列腺癌Gleason评分（Gleason score,GS）的差异。方法：研究前列腺癌GS系统主要指标均值及所占比例,比较穿刺活检（needle biopsy,NB）、经尿道前列腺切除（transurethral resection of the prostate,TURP）以及前列腺切除（prostatectomy,PC）标本中的差异。结果：NB,TURP和PC中GS均值分别为7.14±1.11,7.14±1.32和6.78±0.91,PC中GS均值显著低于NB（P=0.001）和TURP（P=0.029）。GS 5,6,7,8,9和10分在NB中分别占0.4%,33.9%,34.7%,15.3%,13.4%和2.3%;在TURP中分别占4.3%,40.0%,18.6%,17.1%,14.3%和5.7%;在PC中分别占2.6%,39.1%,40.4%,11.3%,6.6%和0;GS 5分在TURP中所占比例显著高于NB（P=0.001）,在PC中显著高于NB（P=0.014）;GS 8分在TURP中所占比例显著高于NB（P=0.007）和PC（P=0.001）;GS 9分在TURP中所占比例显著高于PC（P=0.025）;GS 10分在TURP中所占比例显著高于PC（P=0.003）。结论：不同标本前列腺癌GS存在差异;在三种标本中PC GS最低,TURP GS偏高;前列腺癌早期发现和早期治疗还需要进一步加强。

Different analysis of Gleason score in different prostate carcinoma specimens

Objective：To investigate the differences of Gleason score（GS） among different prostate carcinoma specimens.Methods：The mean level and the proportion of key indicators of GS system were examined,and their difference was analyzed among needle biopsy（NB）,transurethral resection of the prostate（TURP） and prostatectomy（PC）.Results：The mean levels of GS in NB,TURP and PC were 7.14 ± 1.11,7.14 ± 1.32 and 6.78 ± 0.91,respectively; GS in PC was significantly lower than that in NB（P=0.001） and TURP（P=0.029）.GS 5,6,7,8,9 and 10 point in NB accounted for 0.4%,33.9%,34.7%,15.3 %,13.4% and 2.3%,respectively; 4.3%,40.0%,18.6%,17.1%,14.3% and 5.7% in TURP,respectively; 2.6%,39.1%,40.4%,11.3 %,6.6% and 0 in PC,respectively.The proportion of GS 5 point in TURP was significantly higher than that in NB（P=0.001）; PC was significantly higher than that in NB（P=0.014）.The proportion of GS 8 point in TURP was significantly higher than that in NB（P=0.007） and PC（P=0.001）.The proportion of GS 9 point in TURP was significantly higher than that in PC（P=0.025）.The proportion of GS 10 points in TURP was significantly higher than that in PC（P=0.003）.Conclusions：There are significant differences of GS in different prostate carcinoma specimens.In three specimens,GS in PC is lowest,while higher in TURP specimens.Early detection and treatment of prostate carcinoma need to be further strengthened.