格里森得分7升级总是预测更糟糕的预后吗?
Jiatong Zhou1, Minghao Yu1, Jie Ding1
1Department of Urology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Clinical genitourinary cancer
|May 29, 2023
概括
激进前列腺切除术后格里森得分7升级影响预后,特别是在 PSA 4.1-10ng/ml 的男性中. 在特定的前列腺癌患者群体中,这种升级是整体生存的重要风险因素.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 格里森评分 (GS) 对前列腺癌 (PCa) 评分至关重要.
- 从活检到急性前列腺切除 (RP) 标本的GS升级可能会发生.
- 在RP上GS 7升级的临床意义及其预后影响需要进一步阐明.
研究的目的:
- 为了确定格里森得分7升级的临床意义,激进前列腺切除术.
- 调查格里森得分升级对患者预后和整体存活时间 (OS) 的影响.
主要方法:
- 使用了监测,流行病学和最终结果 (SEER) 数据库.
- 包括8832名被诊断为M0前列腺癌 (PCa) 的男性 (GS 3+4/4+3) 接受RP (2010-2015) 治疗.
- 采用后勤和Cox危险回归分析来评估影响GS升级和OS的因素.
主要成果:
- 确定前列腺特异性抗原 (PSA) >20ng/ml,T阶段3-4和淋巴结转移作为GS升级后RP的独立风险因素.
- 黑人种族,GS升级和化疗是不良操作系统的重要预测因素.
- 活检GS升级显示,PSA为0-4ng/ml和4.1-10ng/ml的患者中,与糟糕的生存系统有显著的关联.
结论:
- 在RP上升格里森得分7并不总是导致更差的预后.
- 活检GS 7升级是不良OS的独立风险因素,特别是在PSA 4.1-10ng/ml的患者中.
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