346例前列腺癌的Gleason评分分布特征及其与临床分期的关系

目的:探讨前列腺癌患者G leason评分分布特征及其与临床分期的关系。方法:收集我院1992年1月~2005年6月346例前列腺癌病例资料,建立临床资料数据库,对病理切片进行G leason评分。将病例按不同年份分成3组:1992~1999年、2000~2002年和2003年~2005年6月。采用χ2检验分析G leason评分分布及各组间差异,采用Spearm an等级相关分析,分析前列腺癌G leason评分与临床分期的关系。结果:3组间G leason评分分布差异有显著性(χ2=17.703,P<0.01),G leason评分平均值稍有降低,G leason评分5~7分前列腺癌比例增加(χ2=10.736,P<0.01),临床意义较大的G leason评分7、8、9、10分作为一组,其比例无显著变化(χ2=4.038,P>0.05)。346例前列腺癌中,G leason评分2~6分预测局限性前列腺癌与G leason评分7分和8~10分差异有显著性(χ2=8.786,P<0.01,χ2=22.956,P<0.01),G leason评分7分和8~10分预测局限性前列腺癌差异无显著性(χ2=0.787,P>0.05)。G leason评分与临床分期相关(r=0.452,P<0.01)。结论:G leason评分7分与G leason评分8~10分在预测肿瘤进展方面具有相似效应。G leason评分与临床分期有关,提示其可能是判断前列腺癌预后的一个有意义的指标。

Distribution Features of Gleason Score and Its Relationship with Clinical Stages in 346 Prostate Cancer Patients

OBJECTIVE: To analyze the distribution features of Gleason score and evaluate the relationship between Gleason score and clinical stages in patients with prostate cancer. METHODS: Surveys were made of the inpatients with prostate cancer diagnosed by pathology from January 1992 to June 2005 in our hospital. Gleason score and clinical stages were determined on the basis of pathological examination and clinical data of the prostate cancer patients. The patients were divided into three groups (1992-1999, 2000-2002 and 2003-2005). The Chi-square test was used to evaluate the distribution and differences of Gleason score among the three groups. Spearman rank correlation was applied to the evaluation of the relationship between Gleason score and clinical stages. RESULTS: We found a statistically significant shift in the distribution of Gleason score (chi2 = 17.703, P < 0.01), and a slight increase in the mean Gleason score. The proportion of moderately differentiated tumor increased (chi2 = 10.736, P < 0.01). There was little change in the proportion of Gleason score 7, 8, 9 and 10 (chi2 = 4.038, P > 0.05). Gleason score had a significant positive correlation with clinical stages in the 346 cases of prostate cancer (r = 0.452, P < 0.01). Significant difference was observed between Gleason score 2-6 and 7 or 8-10 (chi2 = 8.786, P < 0.01, chi2 = 22.956, P < 0.01), but not between the latter 2 groups (chi2 = 0.787, P > 0.05) in prediction of organ-confined disease. CONCLUSIONS: Gleason score 7 shows the similar value to Gleason score 8-10 in predicting the progression of the disease. Gleason score was significantly correlated with clinical stages, which suggests that Gleason score is also an important indicator for the prognosis of prostate cancer.