Predictive accuracy of transrectal ultrasound-guided prostate biopsy: correlations to matched prostatectomy specimens

Autor: Maria Shevchuk, John A. Fracchia, Gerald Matthews, Marc D. Danziger, Cristina Antonescu
Rok vydání: 1997
Předmět:
Zdroj: Urology. 49:863-867
ISSN: 0090-4295
DOI: 10.1016/s0090-4295(97)00075-7
Popis: Objectives. To characterize observed differences in Gleason score between prostate biopsy and corresponding radical retropubic prostatectomy (RRP) specimens. Methods. One hundred consecutive clinically localized prostate cancers diagnosed by transrectal ultrasound-guided biopsy (TRUS-Bx) and treated with RRP were reviewed. All specimens were evaluated in blinded review by a single expert uropathologist and contrasted with the initial histologic analysis, performed by multiple pathologists. Results. Mean Gleason score of TRUS-Bx specimens for blinded review and at initial evaluation were 6.6 ± 0.1 and 6.0 ± 0.1 (P < 0.001). Corresponding RRP values were 6.8 ± 0.1 and 6.5 ± 0.1 (P < 0.03). Differences in Gleason score between TRUS-Bx and RRP at initial evaluation were significant (P < 0.02), but not in blinded review (P = NS). In blinded review, TRUS-Bx correctly predicted RRP histology for 88% of men with lesions scored as Gleason 5 to 7 and 41% of men with well- (Gleason score of 2 to 4) or poorly differentiated (Gleason score of 8 to 10) lesions (P < 0.01). Conclusions. TRUS-Bx does not accurately reflect RRP histology when predicting well- or poorly differentiated lesions. Prostate cancer treatment algorithms should not be predicated upon biopsy histology alone. Histologic interpretation is more accurate and precise when performed by a single experienced uropathologist.
Databáze: OpenAIRE
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