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[Evidence of the radical prostatectomy Gleason score in the biopsy Gleason score]
F Algaba Arrea1, A Chivite de León, J M Santaularia Segura
1Sección de Patologia de la Fundación Puigvert, Barcelona.
Introduction:
The Gleason score (Gs) for prostatic cancer has a good prognosis correlation after radical prostatectomy, for this reason its correlation with the Gs in the biopsy can be useful.
Patients And Methods:
Two hundred fifteen patients with blind evaluation among three pathologists of their Gs in biopsy and in the corresponding radical prostatectomy specimen are presented.
Results:
The exact coincidence is present in 49.7% of cases, 38.6% of cases are under graded in the biopsy and 11.6% of them over graded in the biopsy. No cases of Gs 2 in the biopsy are found. Any case with Gs 3 and 4 in the biopsy are reproduced in the radical prostatectomy specimen. The exact coincidence for biopsy Gs 5, 6, 7, 8 and 9 are 25%, 45%, 72.7%, 36.6% and 60% respectively (kappa 0.32 +/- 0.047, p<0.0001 in Gs 5 to 8). The Gleason pattern 4 is the less diagnosed in prostate biopsies [40% of cases with this pattern in the excision specimen it is missing in the biopsy).
Conclusions:
The Gs in the needle prostatic biopsy has a good correspondence with the Gs in the radical prostatectomy specimen. For an increase of the reproducibility it is recommendable avoid the diagnosis of Gs 2, 3 and 4 in biopsy and a scrupulous search for the patterns 4 and 5.
