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目的探讨前列腺癌根治术后Gleason评分升级与术前多参数MRI(mpMRI)前列腺影像报告数据系统(PIRADS)评分的关系。方法回顾性分析198例前列腺癌根治术后患者的资料。根据PI-RADS评分分为低分(1~2分),中分(3分),高分(≥4分)3组。通过单因素和多因素Logistic回归分析探讨PI-RADS评分与Gleason评分的关系。结果单因素分析显示,前列腺特异性抗原密度、前列腺体积、术前穿刺病理Gleason评分、精囊侵犯、穿刺阳性针数、PI-RADS评分是术后Gleason评分升级的影响因子(P均<0.05)。多因素分析显示,前列腺体积(P<0.01)与术前PI-RADS评分(P<0.01)是前列腺癌根治术后Gleason评分升级的独立预测因素。术前PI-RADS评分低分组及中分组术前与术后Gleason评分差异无统计学意义(P均>0.05);而高分组术后Gleason评分高于术前,差异有统计学意义(P<0.05)。结论术前Gleason评分较低(≤6分)而PI-RADS评分较高(≥4分)的小体积前列腺癌患者,术后Gleason评分升级的可能大。
Objective To investigate the relationship between the escalation of Gleason score after radical prostatectomy and preoperative multi-parameter MRI (PMRADS) prostate imaging report system (PIRADS). Methods A retrospective analysis of 198 cases of prostate cancer patients after radical data. According to the PI-RADS score, it was divided into three groups: low score (1-2 points), middle score (3 points) and high score (≥4 points). The relationship between PI-RADS score and Gleason score was investigated by single factor and multivariate Logistic regression analysis. Results Univariate analysis showed that prostate specific antigen density, prostate volume, preoperative pathological Gleason score, seminal vesicle invasion, puncture positive stitch number and PI-RADS score were all the factors influencing the postoperative Gleason score upgrade (all P <0.05). Multivariate analysis showed that prostate volume (P <0.01) and preoperative PI-RADS score (P <0.01) were independent predictors of Gleason score improvement after radical prostatectomy. There was no significant difference in preoperative and postoperative Gleason scores between preoperative and postoperative PI-RADS scores (all P> 0.05), while the Gleason score was significantly higher in preoperative PI-RADS patients than in preoperative patients (P < 0.05). Conclusions Patients with small volumes of prostate cancer who have a low Gleason score (≤ 6 points) and a high PI-RADS score (≥4 points) may have a large Gleason score.