Tayfun ŞAHİNKANAT, Faruk KÜÇÜKDURMAZ, Erkan EFE, Eyüp Koluş, Hasan Çetin EKERBİÇER, Muharrem Bitiren

Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması

Amaç: Prostat biyopsisiile elde edilen Gleason skoru (GS)lokalize prostat kanseri olgularının tedavi kararında önem taşıdığı için radikal prostatektomi (RP)GSile uyumuoldukça önemlidir. Ancak literatürde bu uyum %24-50 arasında bildirilmektedir. Çalışmamızda kliniğimizde yapılan prostat biyopsileri ile RP sonrası elde edilen patolojik bulguların uyumu değerlendirilmiştir.Gereç ve Yöntemler: KSÜ Tıp Fakültesi Üroloji Kliniği'nde standart 12 kor transrektalbiyopsi ile prostat kanseri tanısı konan ve sonraki sekiz haftada RP yapılan 24 hastanın patoloji sonuçları retrospektif olarak değerlendirildi. Biyopsilerde GS, kanserli kor sayısı,kanserli korlardaki kanser yüzdesi değerlendirildi. Ayrıca yaş,prostat hacmi,PSA değerlerininbiyopsi ve RP GS’ları arasındaki uyuma etkisi araştırıldı. GS artışı ya da azalışı bir prognostik gruptan diğerine geçiş olarak tanımlandı.Prognostik gruplar GS 6; 7 ve 8≤ olarak kategorize edildi. Bulgular: Hastaların ortanca yaşı 68 (58-79) yıl,ortanca PSA değeri 9,65 ng/ml (4.2-149) ve prostat hacmi 46.5 ml'ydi (27-70). Tüm hastalar değerlendirildiğinde yalnızca bir olguda (%4.2) GS düşüşü saptandı. Biyopsisinde GS=6 olan olguların %43.5'sinde (n:7/16) RP GS’unda artışısaptanırken, GS=7 olan 7 hastanın ise sadece birinde GS artışı izlendi. GS=8 olan bir hastanın RP GS biyopsi GS’u ile aynıydı. Prostat biyopsi ve patolojik GS arasındaki genel uyum %62.5ve kappa değeri 0,31(p:0,025) idi. GS artışı ile ileri yaş arasında k:0.47 (p=0.01),PSA> 9 olan 14 vaka için k:0.50 (p=0.021) ve prostat hacmi ≥30 cc olan olgularda k:0.42 (p=0.014) olarak bulundu.Sonuç: Çalışmamızda iğne biyopsi GS ile RP GS arasındaki uyum oranı literatürle uyumlu bulunmakla birlikte, verilerimiz biyopsi ile daha doğru derecelendirme için yeni teknik yaklaşımlara yönelmemiz gerektiğini düşündürtmektedir. Anahtar kelimeler: biyopsi, prostat kanseri, Gleason skoru, radikal prostatektomi

Anahtar Kelimeler:

Biyopsi, prostat kanseri, Gleason skoru, radikal prostatektomi

Comparison Between Needle Biopsy and Radical Prostatectomy Samples in Assessing Gleason Score in Prostatic Adenocarcinomas

Objective: Prostate biopsy Gleason score is important for treatment planning in patients with localized prostate cancer. Therefore, concordance between biopsy and radical prostatectomy (RP) pathologies is critically important. However, discordance rates between those two was reported as 24-50% in the literature. Aim of present study is to evaluate concordance rates between biopsy and RP results.Material and Methods: A retrospective review of 24 patients, who underwent prostate biopsy (standart 12 cores) due to elevated PSA or abnormal digital rectal examination and diagnosed with localised prostate cancer was performed. All patients underwent radical prostatectomy within 8 weeks after biopsy. Associations between preoperative clinical factors and Gleason score upgrading were analyzed. Those factors include Gleason scores, percentage of positive cores, age, prostate volume and PSA value. Gleason upgrading or downgrading was defined as an increase or decrease from one prognostic group to another. Prognostic groups were categorised as GS 6; 7 and 8≤.Results: Median age of patients was68 (58–79) years and median PSA was 9,65 ng/ml (4.2–149). Median prostate volume was 46,5 ml (27–70). Overall, needle biopsies were under-graded in 1 (4.2%) cases, overgraded in 8 (33.3%), and correctly graded in 15 (62.5%) patients. While upgrading was identified in 7 out of 16 (43,5%) patients with GS 6 on needle biopsy, only one patient with GS=7 on biopsy was upgraded. Overall concordance between biopsy and pathological GS was 62.5% (p = 0.025) and k value was 0.31. Independent predictors of upgrading were age (k:0.47 [p=0.01]), PSA> 9 (k:0.50 [p=0.021]) and prostate volume ≥30 cc (k:0.42 [p=0.014]). Conclusion: Although our results were consistent with the literature, new approachs are required to better grading with biopsy.

Keywords:

Biopsy, prostate cancer, Gleason score, radical prostatectomy,

Tam Metin

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Bibtex	@araştırma makalesi { ksutfd205510, journal = {Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi}, issn = {1303-6610}, eissn = {2547-9598}, address = {}, publisher = {Kahramanmaraş Sütçü İmam Üniversitesi}, year = {2017}, volume = {12}, number = {1}, pages = {25 - 30}, doi = {10.17517/ksutfd.205510}, title = {Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması}, key = {cite}, author = {Şahinkanat, Tayfun and Küçükdurmaz, Faruk and Efe, Erkan and Koluş, Eyüp and Ekerbiçer, Hasan Çetin and Bitiren, Muharrem} }
APA	Şahinkanat, T. , Küçükdurmaz, F. , Efe, E. , Koluş, E. , Ekerbiçer, H. Ç. & Bitiren, M. (2017). Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması . Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi , 12 (1) , 25-30 . DOI: 10.17517/ksutfd.205510
MLA	Şahinkanat, T. , Küçükdurmaz, F. , Efe, E. , Koluş, E. , Ekerbiçer, H. Ç. , Bitiren, M. "Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması" . Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi 12 (2017 ): 25-30 <
Chicago	Şahinkanat, T. , Küçükdurmaz, F. , Efe, E. , Koluş, E. , Ekerbiçer, H. Ç. , Bitiren, M. "Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması". Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi 12 (2017 ): 25-30
RIS	TY - JOUR T1 - Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması AU - TayfunŞahinkanat, FarukKüçükdurmaz, ErkanEfe, EyüpKoluş, Hasan ÇetinEkerbiçer, MuharremBitiren Y1 - 2017 PY - 2017 N1 - doi: 10.17517/ksutfd.205510 DO - 10.17517/ksutfd.205510 T2 - Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi JF - Journal JO - JOR SP - 25 EP - 30 VL - 12 IS - 1 SN - 1303-6610-2547-9598 M3 - doi: 10.17517/ksutfd.205510 UR - Y2 - 2016 ER -
EndNote	%0 Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması %A Tayfun Şahinkanat , Faruk Küçükdurmaz , Erkan Efe , Eyüp Koluş , Hasan Çetin Ekerbiçer , Muharrem Bitiren %T Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması %D 2017 %J Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi %P 1303-6610-2547-9598 %V 12 %N 1 %R doi: 10.17517/ksutfd.205510 %U 10.17517/ksutfd.205510
ISNAD	Şahinkanat, Tayfun , Küçükdurmaz, Faruk , Efe, Erkan , Koluş, Eyüp , Ekerbiçer, Hasan Çetin , Bitiren, Muharrem . "Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması". Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi 12 / 1 (Nisan 2017): 25-30 .
AMA	Şahinkanat T. , Küçükdurmaz F. , Efe E. , Koluş E. , Ekerbiçer H. Ç. , Bitiren M. Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması. KSÜ Tıp Fak Der. 2017; 12(1): 25-30.
Vancouver	Şahinkanat T. , Küçükdurmaz F. , Efe E. , Koluş E. , Ekerbiçer H. Ç. , Bitiren M. Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması. Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi. 2017; 12(1): 25-30.
IEEE	T. Şahinkanat , F. Küçükdurmaz , E. Efe , E. Koluş , H. Ç. Ekerbiçer ve M. Bitiren , "Prostat adenokarsinomlarında iğne biyopsileri ve radikal prostatektomi materyallerinin Gleason skoru açısından karşılaştırılması", , c. 12, sayı. 1, ss. 25-30, Nis. 2017, doi:10.17517/ksutfd.205510