title: Correlation of Gleason scores between needle-core biopsy and radical prostatectomy specimens in patients with prostate cancer.
abstract: 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.
authors.affiliation: Department of Urology, China Medical University Hospital and School of Medicine, China Medical University, Taichung, Taiwan, ROC.
authors.forename: Teng-Fu
authors.initials: TF
authors.lastname: Hsieh
authors.forename: Chao-Hsian
authors.initials: CH
authors.lastname: Chang
authors.forename: Wen-Chi
authors.initials: WC
authors.lastname: Chen
authors.forename: Chien-Lung
authors.initials: CL
authors.lastname: Chou
authors.forename: Chang-Chung
authors.initials: CC
authors.lastname: Chen
authors.forename: Hsi-Chin
authors.initials: HC
authors.lastname: Wu
mesh_terms: 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
chemical_list: D017430:Prostate-Specific Antigen