COMPARISON OF GLEASON GRADUATION BETWEEN BIOPSIES AND SURGICAL PIECE IN PATIENTS WITH PROSTATE CANCER

Abstract

Prostate cancer is the most prevalent in men, excluding non-melanoma skin cancer. The Gleason score is most often the main indicator of aggressiveness in prostate cancer, so the results obtained in the biopsy and in the anatomopathological examination of the surgical specimen should be the same. However, for several reasons this often does not happen. The national literature is scarce in discussing the comparison of Gleason grading between biopsies and definitive results of surgical specimens in cases of prostate cancer. Objectives: To compare the Gleason score of pre -surgical biopsies and radical prostatectomy specimens, in patients with prostate cancer, to identify possible factors that influence the discrepancy between the results. Methods: Retrospective, observational, cross-sectional study where the medical records of patients who underwent prostate biopsy diagnosed with Usual Acinar Adenocarcinoma and who later underwent radical prostatectomy in a private teaching hospital, of a philanthropic nature, located in the city of Curitiba/ Paraná/ Brazil were analyzed. , between January 2014 and December 2018. Gleason scores were obtained from the biopsies and compared to the surgical specimens. The following parameters were also analyzed: 1) blood level of prostate-specific antigen (PSA), 2) Patient's age 3) Prostate size of the surgical specimen 4) Presence of a nodule on digital examination of the prostate. The findings were statistically treated by the one test methods way ANOVA, Kruskal - Wallis test and Mann Whitney test with admission of significance for p< 0.05. Results: In the 115 patients evaluated, a mean age of 65.5 years was found, ranging from 47 to 83. Comparing the data, it was possible to identify 27 cases in which the Gleason score increased in the surgical specimen (23.47%), 13 cases decreased (11.30%) and 75 cases remained the same (65.21%). The mean prostate size was 38.4cc, ranging from 5.3 to 178. The mean prostate-specific antigen (PSA) was 10.63 ng /ml, ranging from 0.67 to 43.59, with a median of 8. Nodules were detected on digital examination of the prostate in 70 patients. patients (60.89%) In the study of variables according to changes in the Gleason score, age presented p=0.54, PSA p=0.75, prostate size p=0.01 and presence of prostatic nodules p = 0.49. Conclusion: In the present study, the concordance of the Gleason score of the pre -surgical prostate biopsy with the prostatectomy was exact in 65.21% of the cases and the factors analyzed that significantly influenced the variation of the score was the size of the prostate.