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目的分析前列腺癌患者穿刺标本与根治术标本Gleason评分的相关性,探讨影响穿刺标本Gleason评分准确性的可能因素。方法回顾性分析86例接受根治性前列腺切除术的前列腺癌患者资料,比较穿刺标本与根治术标本Gleason评分的符合情况,应用二分类Logistic回归分析筛选影响穿刺标本Gleason评分准确性的可能因素。结果 86例患者穿刺标本平均Gleason评分为6.1,根治术标本平均Gleason评分为6.5,穿剌标本与根治术标本Gleason评分相比,评分相符42例(48.8%),评分偏低32例(37.2%),评分偏高12例(14.0%),差异具有统计学意义(P<0.05),偏差与患者年龄、血清PSA、前列腺体积、临床分期无显著相关性(P>0.05),与穿刺针数(OR=2.905)及穿刺阳性率(OR=4.225)有显著相关(P<0.05)。结论穿刺针数与穿刺阳性针数百分比是影响穿刺标本Gleason评分准确性的可能因素,增加前列腺穿刺活检针数将可能有助于提高穿刺标本预测前列腺癌病理分级的准确性。
Objective To analyze the correlation between the Gleason score and the Gleason score in patients with prostate cancer and explore the possible factors that influence the accuracy of the Gleason score. Methods The data of 86 prostate cancer patients undergoing radical prostatectomy were retrospectively analyzed. The compliance of the Gleason score between the punctured and radical specimens was compared. Two-factor Logistic regression analysis was used to screen the possible factors that affect the accuracy of the Gleason score. Results The average Gleason score of the puncture specimens in 86 patients was 6.1. The average Gleason score of the specimens was 6.5. The score of the puncture specimens was 42 (48.8%) and 32 (37.2%) lower than the Gleason score. ), The score was high in 12 cases (14.0%), the difference was statistically significant (P <0.05). There was no significant correlation between the deviation and patient’s age, serum PSA, prostate volume and clinical stage (OR = 2.905) and positive rate of puncture (OR = 4.225) (P <0.05). Conclusions The number of puncturing needles and puncturing positive needles are the possible factors influencing the accuracy of Gleason score in puncture specimens. Increasing the number of needle biopsies may help to improve the accuracy of puncture specimens in predicting the pathological grading of prostate cancer.