Gürhan GÜNAYDIN, Çağ ÇAL, Mustafa DELİBAŞ, Derya KESKİN, Mine HEKİMGİL, İbrahim CÜREKLİBATIR

Tanısal biyopsi ve radikal prostatektomi materyallerinde belirlenen Gleason skorlarının uyumu

Prostatektomi materyalinin Gleason skoruyla prostat kanserinin lokal invazyonu ve metastatik potansiyeli arasında güçlü bir bağlantı olduğu bilinmektedir. Bu çalışmanın amacı tanısal iğne biyopsisi ve radikal prostatektomi materyallerinde belirlenen Gleason skorlarının uyumunu ve bu uyumun klinik evrelemedeki rolünü belirlemektir. Lokalize prostat kanseri tanısıyla radikal prostatektomi uygulanan 40 olgunun cerrahi spesmen ve iğne biyopsisi materyallerinde saptanan Gleason skorları karşılaştırıldı. Biyopsi ve cerrahi spesmendeki Gleason skorlarının %67.5 aynı olduğu görüldü. Hatalı düşük biyopsi Gleason skoru iyi, orta ve kötü diferansiye tümörlerde sırasıyla %28.57, %9.09 ve %18.18 olarak bulundu. Hatalı yüksek dereceleme iyi ve orta diferansiye tümörlerde sırasıyla %28.57 ve %22.72'dir. Prostatektomi materyalinde, iyi diferansiye tümörlerde %14.28 ve kötü diferansiye tümörlerde %81.81 lokal ileri evre hastalık saptandı. Kötü diferansiye tümörlü 4 olguda pelvik lenf nodu metastazı gösterildi. Düşük biyopsi Gleason skorunun doğruluğu uygulanacak tedavinin kesin olarak belirlenmesini sağlamaktan uzaktır. Yüksek biyopsi Gleason değeri prognozun kötü olabileceğini gösterse de klinik lokalize prostat kanserinde biyopsi Gleason skoru tek başına cerrahi öncesi prognozu, patolojik evreyi ve lenf nodu metastazlarını belirlemede yetersizdir.

Anahtar Kelimeler:

Biyopsi, iğne, Seyir, Prostatektomi, Prostat neoplazmları

Correlation between the Gleason's scores of diagnostic biopsy and radical prostatectomy specimens

It is known that there is a strong correlation between local invasion and metastatic potential of the prostatic carcinoma, and Gleason's score of the prostatectomy specimen. The aim of this study is to evaluate the correlation between the Gleason's score of diagnostic core needle prostate biopsies and radical prostatectomy specimens, and also to determine its role in clinical staging. The Gleason's scores of core needle biopsies and the surgical specimens of the 40 patients, who underwent radical prostatectomy with diagnosis of localised prostate cancer, were compared. The biopsy and surgical specimen Gleason's scores were same in 67.5% of patients. It was detected that the underestimated biopsy Gleason's scores in the well, moderate and poorly differentiated tumors were 28.57%, 9.09% and 18.18% respectively. The overestimated biopsy Gleason's scores in the well and moderate differentiated tumors were 28.57% and 22.72% respectively. Local advanced disease was observed 14.28% of well-differentiated and 81.81% of poor differentiated tumor in prostatectomy specimens. Pelvic lymph node involvement was shown in 4 patients with poor differentiated tumor. The accuracy of low biopsy Gleason's score is not enough to select the correct treatment modality. Although high biopsy Gleason's scores may indicate poor prognosis, Gleason's score of the biopsy is not sufficient to determine preoperative prognosis, pathological stage and lymph node metastasis.

Keywords:

Biopsy, Needle, Prognosis, Prostatectomy, Prostatic Neoplasms,

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