Prostat iğne biyopsisi ve radikal prostatektomi materyallerinde gleason skorlarmm karşılaştırılması

Comparison of the gleason scores of prostate needle biopsies and radical prostatectomy specimens gleason score in prostatic adenocarcinoma

Kemal KÜR?AT BOZKURT,Mustafa KIZMAZ,Gülsün İnan MAMAK,İsmail KORKMAZ,Sema BİRCAN

Özet

Amaç: Gleason skoru (GS) prostat kanserinde önemli bir prognostik belirteç olup evre ve prognozlakuvvetli korelasyon göstermektedir. Ancak prostat i?ne biyopsilerine (?B) ve radikal prostatektomi (RP)materyallerine verilen skorlar her zaman uyum göstermemektedir. Çal??mam?zda ?B ve RPlere verilenGSlerin tan?sal uyumlulu?u ara?t?r?lacakt?r. Gereç ve Yöntem: Çal??maya prostat ?Bde adenokarsinom tan?s?alarak RP operasyonu geçirmi? 51 olgu al?nd?. Her iki materyale verilen GSler kar??la?t?r?larak verilenskorlar?n tan?sal uyumlulu?u ara?t?r?ld?. Ayr?ca olgulara ait serum prostat spesifik antijen (PSA) seviyeleriile ?Bde tümör içeren kadran say?s?n?n tan?sal uyuma etkisi incelendi. Bulgular: Prostat ?B GSleri s?ras?yla43 (%84,3) olguda 6, 7 (%13,7) olguda 7 ve 1 (%2) olguda 9 idi. Elli bir olgunun 35inde (%68,6) ?B ve RPGSlerinde tam uyum vard?. ?Bde GS 6ya sahip 43 olgunun 28inde (%65,1) ve GS 7ye sahip 7 olgununtamam?nda (%100) RP materyaliyle tam uyum vard?. Bu oranlar GS 6 ve 7nin pozitif prediktif de?erleriydi.On be? (%29,4) olgunun ?B materyalinde GS, RP materyalinin skorundan dü?ükken, 1 (%2) olguda dahayüksek idi. Prostat ?Blerinde tümör pozitif kadran say?s?n?n ve serum PSA seviyesinin GS uyumlulu?unaanlaml? etki yapmad??? saptand? (p>0,05). Sonuç: Gleason skorlama sistemi prostat adenokarsinomundatedavi ve prognozu belirlemede önemli bir parametredir. Bu nedenle ?Bde verilen GSnin RP materyalindekiGS ile uyumun sa?lanmas? tedaviyi belirlemede önemlidir

Abstract

Aim: Gleason score (GS) is an important prognostic marker for prostate cancer and it is strongly correlatedwith stage and prognosis. However, needle biopsy (NB) GS is not always consistent with that of radicalprostatectomy (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 adenocarcinomaby prostate NB and underwent RP operation. The GSs of both specimens were compared and their correlationwas investigated. In addition, the effect of blood prostate-specific antigen (PSA) levels and number of tumorpositive quadrants in NBs on the correlation was also examined. Results: Gleason scores of NBs were 6, 7and 9 in 43 (84.3%), 7 (13.7%) and 1 (2%) patients respectively. Exact correlation existed between GSs of NBand RP specimens for 35 (68.6%) cases. Positive predictive values for biopsy GSs 6 and 7 were 65.1% and100%, respectively. Fifteen (29.4%) biopsies were undergraded and 1 (2%) was overgraded. Blood PSA levelsand 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 prostatecancer. Thereby, it is important to provide a correlation between GSs of prostate NBs and RP specimens forthe treatment