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目的:研究前列腺腺癌(PCa)Gleason评分重复性。方法:收集49例PCa病例,依据国际泌尿病理协会((ISUP)修订的Gleason评分系统,采用组合和分组方法进行Gleason评分,观察重复性和差异性。结果:15位病理医生总体Gleason评分重复性较好(κ=0.642);Gleason评分组合重复性62.2%,重复性最高者Gleason评分5+5(81.2%)和5+4(73.3%);其次是4+4(67.5%)、3+3(64.0%)、4+3(61.3%)及3+4(44.0%);最低者Gleason评分4+5(38.9%)和Gleason评分3+5(33.3%)。Gleason评分总分分组重复性71.4%,重复性最高者为Gleason评分9~10分(84.9%),其次是Gleason评分7分(76.7%),最低者为Gleason评分6分(64.0%)和8分(60.7%)。结论:PCa Gleason评分重复性还有待进一步提高,主要问题在于Gleason 3级癌和4级癌的认识。
Objective: To study the reproducibility of Gleason score for prostate cancer (PCa). Methods: According to the Gleason score system revised by the International Association of Urological Pathology (ISUP), 49 cases of PCa were collected and the Gleason score was used to evaluate the repeatability and difference.Results: The overall Gleason score repeatability of 15 pathologists (81.2%) and 5 + 4 (73.3%), respectively; followed by 4 + 4 (67.5%), 3+ Gleason score 4 + 5 (38.9%) and Gleason score 3 + 5 (33.3%). The Gleason score was divided into 3 groups (64.0%), 4 + 3 (61.3%) and 3 + 4 (71.4%), the Gleason score was 9-10 (84.9%), followed by the Gleason score was 7 (76.7%), the lowest was Gleason score 6 points (64.0%) and 8 points (60.7%). Conclusion: PCa Gleason score repeatability remains to be further improved, the main problem is Gleason 3 and 4 cancer awareness.