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- Title
Accurate Gleason Grading of Prostatic Adenocarcinoma in Prostate Needle Biopsies by General Pathologists.
- Authors
Renshaw, Andrew A.; Schultz, Delray; Cote, Kerri; Loffredo, Marian; Ziemba, David E.; D'Amico, Anthony V.
- Abstract
Context.--Gleason grading of prostatic adenocarcinoma in core needle biopsies is important for predicting prognosis and selecting appropriate therapy. Previous studies have shown that Gleason scores assigned by general pathologists have a low correlation with those assigned by urologic pathologists, and that general pathologists tend to undergrade prostate carcinoma. Objective.--To determine if the performance of general pathologists grading prostate needle biopsies has changed over time. Design.--Four hundred sixteen prostate biopsies from men treated at a single community-based institution between 1987 and 2000 were reviewed by one urologic pathologist (A.A.R.). The correlation between the original Gleason score and the reviewer's score was determined over time. Results.--Cases were divided into those performed and originally interpreted in the first half of the study (1987-1996) and those performed and originally interpreted in the second half (1996-2000). Overall concordance for exact Gleason score was 59% (244/416). The exact concordance of the Gleason score assigned by the original pathologist and the reviewer during the first half of the study was 51%, whereas in the second half of the study the concordance was significantly greater (66.3%, P 5 .002). However, when grouped into score categories of 6 or less, 7, and 8 or greater, there was no significant difference in the exact concordance between the first half of the study (78.3%) and the second half (78.4%). Fifty-five percent of the cases in which there was discordance were graded as 7 by the reference pathologist and 6 or less by the original pathologist. There was no correlation between concordance in Gleason score and the percentage of tissue involved by carcinoma. Conclusion.--The concordance between general pathologists Gleason grading and that of a reference pathologist in this study is much higher than that in previously reported studies. Although exact...
- Subjects
PROSTATE cancer; ADENOCARCINOMA; CANCER; NEEDLE biopsy; CLINICAL pathology
- Publication
Archives of Pathology & Laboratory Medicine, 2003, Vol 127, Issue 8, p1007
- ISSN
0003-9985
- Publication type
Article
- DOI
10.5858/2003-127-1007-aggopa