格里森分数提供比年级组更准确的预后信息
Lars Egevad1, Chiara Micoli2, Brett Delahunt3
1Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Pathology
|February 9, 2025
概括
报告详细的格里森得分,而不仅仅是国际泌尿病学会 (ISUP) 的成绩,对于准确预测前列腺癌的结果至关重要. 高度前列腺癌在ISUP等级内表现出显著差异.
科学领域:
- 尿道瘤学 尿道瘤学
- 癌症预后 癌症预后
- 病理学报告 病理学报告
背景情况:
- 前列腺癌分级通常使用格里森分数和国际泌尿病学学会 (ISUP) 的分数.
- 集ISUP等级组 格里森分数用于简化报告.
- 以前的研究还没有完全阐明高度前列腺癌的预后差异.
研究的目的:
- 为了研究格里森的预后异质性,格里森得分为8-10前列腺癌.
- 为了比较与特定格里森分数相关的结果与更广泛的ISUP等级分组.
- 评估当前ISUP级推对高等级前列腺癌的临床效用.
主要方法:
- 对172,112名通过针活检诊断出前列腺癌的男性基于人口的注册数据的分析.
- 利用前列腺癌死亡率和全因死亡率作为终点.
- 对不同的格里森分数 (例如,3+5,4+4,5+3,4+5,5+4,5+5) 和相应的ISUP等级 (4和5) 的预后结果进行比较.
主要成果:
- 在ISUP 4级 (3+5,4+4,5+3) 和ISUP 5级 (4+5,5+4,5+5) 内的格里森分数之间观察到显著的预后异质性.
- 当格里森分数被分解为ISUP等级4和5时,这种异质性就消失了.
- 在ISUP等级之间注意到了预后重叠,格里森分数5+3和4+5显示了类似的结果 (例如,前列腺特异性5年死亡率:0.32与0.30).
结论:
- 报告个人格里森得分对于高度前列腺癌的精确预后信息至关重要.
- 目前将格里森分数分组为ISUP等级可能会掩盖重要的预后差异.
- 目前对高度前列腺癌的ISUP级推的临床价值需要重新评估.
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