Correlation of Gleason scores between needle-core biopsy and radical prostatectomy specimens in patients with prostate cancer.
BACKGROUND
The histologic grade of a prostate needle-core biopsy specimen can determine whether a patient with prostate cancer is a candidate for radical prostatectomy or other treatment. Incorrect histologic grading can result in inappropriate treatment and possible liability. Thus, we conducted this study to determine the histologic-grading accuracy of prostate cancer needle-core biopsy specimens.


METHODS
Fifty-two patients with localized prostate cancer treated with radical prostatectomy were included in the study. The overall correlation between Gleason scores for needle-biopsy and prostatectomy specimens was evaluated by analyzing the following parameters: biopsy-core number; accurate biopsy-core length; prostate volume; and preoperative, serum prostate-specific antigen (PSA) level. A "downgrade" was defined as the Gleason score for the prostatectomy specimen being greater than that for the biopsy specimen, whereas an "upgrade" was defined as the converse.


RESULTS
No difference in Gleason scores was noted for 31% of specimens, whereas a downgrade was noted for 40%, and an upgrade for 29%. The accuracy of Gleason scores for biopsy specimens taken by the sextant systemic-biopsy method increased when specimens were >15 mm in length. No correlation was noted between difference in Gleason scores and biopsy-core number, prostate volume, and preoperative serum PSA level.


CONCLUSIONS
The accuracy of Gleason scores determined by needle biopsy in patients with prostate cancer seems to be unreliable. Therefore, further evaluation of patients is necessary. No correlations were noted between biopsy-measured errors in Gleason score and biopsy number, prostate volume, or preoperative serum PSA level.
Hsieh
Teng-Fu
TF
Department of Urology, China Medical University Hospital and School of Medicine, China Medical University, Taichung, Taiwan, ROC.
Chang
Chao-Hsian
CH
Chen
Wen-Chi
WC
Chou
Chien-Lung
CL
Chen
Chang-Chung
CC
Wu
Hsi-Chin
HC
D000368:Aged; D001707:Biopsy, Needle; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011467:Prostate / Q000473:pathology* / Q000601:surgery; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy / Q000592:standards*; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D015203:Reproducibility of Results
D017430:Prostate-Specific Antigen