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全球与个体评分,当从单个系统活检部位的前列腺针芯显示格里森评分异质性时
Olalekan K Lanipekun1, Ying Wang1, Hiroshi Miyamoto2
1Department of Pathology & Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA.
Human pathology
|February 16, 2026
概括
从前列腺活检核心报告不同的格里森得分/等级组 (GG) 是有争议的. 这项研究表明,个人核心评分提供了比前列腺癌的全球评分更准确的风险分层.
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:
- 在前列腺癌诊断中的格里森评分/等级组 (GG) 可能是复杂的,当来自同一地点的活检核产生不同的结果时.
- 目前的报告方法包括全球分级或个人核心分级,目前正在就最佳方法进行辩论.
研究的目的:
- 为了确定报告前列腺癌的最佳方法,当来自单个活检部位的多个核心显示不同的等级时,Gleason分数/等级组.
- 评估个人核心评分是否与全球评分相比提供了更准确的风险分层.
主要方法:
- 两组经过激进前列腺切除术的患者的回顾性分析,在单个部位的活检核中具有不同的格里森得分/等级组.
- 混合级核的患者和单级核的对照患者之间的升级率和术后生化复发的比较.
- 单变量和多变量分析,以评估活检结果与复发风险之间的关联.
主要成果:
- 与对照组相比,患有混合级核 (GG3/GG1-2或GG4/GG1-3) 的患者在前列腺切除术上升级率显著更高 (分别为52.0%与16.7%和54.3%与13.3%).
- 在具有整体GG2癌症的病例中,高等级核心 (GG3) 的存在与术后生化复发的显著更高风险有关 (HR 3.177).
结论:
- 从单个活检部位对前列腺针芯的个别评分可能比全球评分提供更精确的风险分层.
- 这种方法可能会导致更好的患者管理和前列腺癌的治疗决策.
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