【摘要】 目的 分析前列腺癌根治术病人手术前后分期及分级的差异及其相关危险因素。 方法 对55例前列腺癌根治术病人手术前后的分期及分级进行总结。 结果 本组55例中术前临床分期为T1～T2期为50例，50例中21例术后病理分期为T3～T4期，占42%。26例术前穿刺活检病理Gleason评分2～6分病人中11例术后病理分级为7～10分，占42%。Logistic回归分析筛选出血清PSA(P=0.0159)及前列腺穿刺阳性针数的百分率(P=0.0013)是预测术前临床分期低于术后病理分期的危险因素。 结论 前列腺癌根治术病人中42%术前临床分期低于术后病理分期，42%术前穿刺病理分级低于术后病理分级。血清PSA水平及穿刺的阳性针数百分率是前列腺癌根治术病人预测分期是否偏低的危险因素。对于临床分期为T1～T2期而血清PSA≥20ng/ml或前列腺穿刺阳性针数≥50%的病人应考虑到临床分期偏低的可能。

    【关键词】 前列腺癌 根治术 肿瘤分期 肿瘤分级

    Comparison clinical T stage and biopsy Gleason score with pathological T stage and prostatectomy Gleason score of patients undergoing radical prostatectomy

    Wang Yuguo

    Tangshan Iron and Steel Company Hospital，Hebei036000.

    【Abstract】 Objective We determined the prevalence of under staging and under grading in contemporary pa-tients undergoing radical prostatectomy and defined important predictors of under staging in this population.Methods We compared clinical T stage and biopsy Gleason score with pathological T stage and prostatectomy Gleason score in55patients.Results Under staging occurred in42%and under grading in42%.Logistic regression analysis re-vealed that PSA at diagnosis(P=0.0159)and the percent of positive biopsies(P=0.0013)were significant predictors of under staging.Conclusion PSA at diagnosis and the percent of positive biopsies are important predictors of under staging.The effect was most evident in patients with high risk disease on PSA greater than20ng/ml and percent of positive biopsies greater than50%. ......