Eur J Surg Oncol. 2025 Oct 30;52(1):111160. doi: 10.1016/j.ejso.2025.111160. Online ahead of print.
ABSTRACT
OBJECTIVE: By comparing with the actual Gleason score findings of whole-prostate organ sections, this study aimed to evaluate the consistency between the overall biopsy score, the highest biopsy score, and the score grouping of cases with an actual Gleason score 3 + 4 or 4 + 3.
PATIENTS AND METHODS: The present study adopted one hundred and twenty-four prostate cancer cases that were admitted to our center between January 2023 and January 2025. All cases underwent prostate biopsy at our center, and were subsequently diagnosed with prostate cancer. Radical prostatectomy was then carried out. Whole-prostate organ sections were prepared from the postoperative specimens, and the pathological reports indicated a Gleason score 3 + 4 or 4 + 3. The Gleason scores of all positive biopsy cores and the pre-biopsy prostate magnetic resonance imaging (MRI) findings of the included cases were collected. The biopsy outcomes of these cases were scored using both the overall biopsy score and the highest biopsy score. These scores were then compared with the actual Gleason score to assess the consistency of the two different score approaches with the actual Gleason score. Subsequently, a further analysis was conducted to determine the impact of MRI results on the consistency between the two score methods and the actual Gleason score. Statistical analysis was performed using the SPSS 26 software package.
RESULT: Among the 124 enrolled cases, the concordance rate between the overall biopsy score and the actual Gleason score was 64.5 % (n = 80). Specifically, in the Gleason score 3 + 4 group, the concordance rate was 66.2 % (n = 51), and in the Gleason score 4 + 3 group, it was 61.7 % (n = 29). The concordance rate between the highest biopsy score and the actual Gleason score was 47.6 % (n = 59). Among them, in the Gleason score 3 + 4 group, the concordance rate was 49.4 % (n = 38), and in the Gleason score 4 + 3 group, it was 42.6 % (n = 21). A statistically significant difference was observed in the concordance rates between the two scoring methods and the actual Gleason score (64.5 % vs. 47.6 %, P < 0.05). Through the analysis of pre-biopsy MRI data, the results indicated that when the Prostate Imaging Reporting and Data System (PI-RADS) score ≥3, the concordance of both scoring methods with the actual Gleason score was significantly enhanced (P < 0.05). Furthermore, when the PI – RADS score≥ 3, the accuracy of the overall biopsy score remained superior to that of the highest biopsy score (71.6 % vs. 54.3 %, P < 0.05).
CONCLUSION: In cases with the actual Gleason score of 3 + 4 or 4 + 3, when both Gleason score 3 and Gleason score 4 components are concurrently detected in the needle biopsy results, the consistency between the overall biopsy score and the actual Gleason score is higher than that of the highest biopsy score. When magnetic resonance imaging (MRI) reveals well – defined target lesions, the consistency of both the overall biopsy score and the highest biopsy score with the actual Gleason score is significantly enhanced. Moreover, the overall biopsy score remains superior to the highest biopsy score.
PMID:41176817 | DOI:10.1016/j.ejso.2025.111160
