title: Predictive accuracy of transrectal ultrasound-guided prostate biopsy: correlations to matched prostatectomy specimens.
abstract: OBJECTIVE
  To characterize observed differences in Gleason score between prostate biopsy and corresponding radical retropubic prostatectomy (RRP) specimens.
  
  
  METHODS
  One hundred consecutive clinically localized prostate cancers diagnosed by transrectal ultrasound-guided biopsy (TRUS-Bx) and treated with RRP were reviewed. All specimens were evaluated in blinded review by a single expert uropathologist and contrasted with the initial histologic analysis, performed by multiple pathologists.
  
  
  RESULTS
  Mean Gleason score of TRUS-Bx specimens for blinded review and at initial evaluation were 6.6 +/- 0.1 and 6.0 +/- 0.1 (P < 0.001). Corresponding RRP values were 6.8 +/- 0.1 and 6.5 +/- 0.1 (P < 0.03). Differences in Gleason score between TRUS-Bx and RRP at initial evaluation were significant (P < 0.02), but not in blinded review (P = NS). In blinded review, TRUS-Bx correctly predicted RRP histology for 88% of men with lesions scored as Gleason 5 to 7 and 41% of men with well-(Gleason score of 2 to 4) or poorly differentiated (Gleason score of 8 to 10) lesions (P < 0.01).
  
  
  CONCLUSIONS
  TRUS-Bx does not accurately reflect RRP histology when predicting well- or poorly differentiated lesions. Prostate cancer treatment algorithms should not be predicated upon biopsy histology alone. Histologic interpretation is more accurate and precise when performed by a single experienced uropathologist.
authors.affiliation: Division of Urology, Lenox Hill Hospital, New York, NY 10021, USA.
authors.forename: M
authors.initials: M
authors.lastname: Danziger
authors.forename: M
authors.initials: M
authors.lastname: Shevchuk
authors.forename: C
authors.initials: C
authors.lastname: Antonescu
authors.forename: G J
authors.initials: GJ
authors.lastname: Matthews
authors.forename: J A
authors.initials: JA
authors.lastname: Fracchia
mesh_terms: D001706:Biopsy; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography