Sažetak | Cilj istraživanja: Cilj ovog rada je dokazati povezanost između Gleasonovog zbroja i dobi bolesnika u trenutku postavljene dijagnoze raka prostate, nakon transrektalne biopsije prostate.
Ispitanici i metode: U razdoblju od 15. rujna 2003. godine do 31. prosinca 2017. retrospektivnim uvidom u ambulantne protokole i patohistološke nalaze TRUS - biopsija, pronađeno je 2560 muškaraca s dijagnozom adenokarcinoma prostate. Kriterij isključenja je bio nedostatna informacija o Gleasonovom zbroju. Isključen je 21 ispitanik (0,82%). Istraživanje je provedeno na Zavodu za urologiju KBC-a Split. Na temelju dobi u trenutku dijagnoze, 2539 bolesnika je podijeljeno u dobne skupine.
Rezultati: U istraživanje je uključeno 2539 bolesnika kojima je dijagnosticiran adenokarcinom prostate na temelju patohistološkog nalaza TRUS-biopsije. Medijan životne dobi svih bolesnika iznosio je 70,5 godina. Gleasonov zbroj 6 ima od 45,2% do 47,4% bolesnika dobi od 50 do 69 godina, a samo 18,2% bolesnika dobi od 90 do 95 godina. Gleasonov zbroj 7 ima 45,5% bolesnika dobne skupine od 46 do 49 godina, dok u skupinama od 55 do 59 godina i 65 do 69 godina zbroj 7 ima 26,3%, odnosno 28,7% bolesnika. Gleasonov zbroj 8 u dobnoj skupini od 46 do 49 godina nema nijedan bolesnik, dok u skupinama od 85 do 89 godina i 90 do 95 godina ima 17,5%, odnosno 27,3% bolesnika. Gleasonov zbroj 9 ima 9,1% bolesnika dobi od 46 do 49 godina i 90 do 95 godina, dok dobna skupina od 80 do 84 ima 9,0% bolesnika. Gleasonov zbroj 10 ima 3,4% bolesnika u dobnoj skupini od 80 do 84 godine i 5,0% bolesnika u skupini od 85 do 89 godina. Sve ostale dobne skupine imaju vrijednosti ispod 0,8%. U našem istraživanju Gleasonov zbroj 8 ili više ima 20,9% bolesnika starijih od 75 godina i 13,3% bolesnika mlađih od 75 godina života. Prognostičkoj skupini 1 pripada od 58,5% do 63,6% bolesnika dobi od 55 do 69 godina. Samo 27,3% bolesnika dobi od 90 do 95 godina pripada prognostičkoj skupini 1. Prognostičkoj skupini 2 pripada 45,5% bolesnika dobi od 46 do 49 godina, a samo 16,3% bolesnika dobi od 80 do 84 godine. Najmlađa skupina nema nijednog bolesnika u prognostičkoj skupini 3, dok dobna skupina od 85 do 89 godina ima 15,0%. Prognostička skupina 4 također nema ni jednog bolesnika iz najmlađe skupine, dok skupine od 85 do 89 godina i 90 do 95 godina imaju 17,5%, odnosno 27,3%. Prognostičkoj skupini 5 pripada 9,1% bolesnika iz dobnih skupina od 46 do 49 godina i 90 do 95 godina.
Zaključci: Udjeli Gleasonovih zbrojeva 8, 9 i 10 rastu s dobi bolesnika. Stariji bolesnici se u većem udjelu svrstavaju u lošije gradusne i rizične skupine. Također bolesnici mlađi od 55 godina imaju veću učestalost Gleasonovog zbroja 8 i 9. |
Sažetak (engleski) | Objectives: The aim of this study is to show association between Gleason's sum and patient's age at diagnosis of prostate cancer, after transrectal biopsy of the prostate.
Patients and methods: From September 15th 2003 to December 31st 2017, using retrospective review of TRUS - biopsy protocols and medical reports, we found 2,560 men with diagnosis of prostate adenocarcinoma. The exclusion criteria was missing information on Gleason score. 21 (0.82%) patients were excluded from the study. The study was conducted at The Department of Urology, University Hospital of Split. Based on the age at diagnosis, 2,539 patients were divided into age groups.
Results: The study included 2,539 males diagnosed with prostate adenocarcinoma based on the pathohistological finding of TRUS-biopsy. The median age of all subjects was 70.5 years. Gleason's sum 6 had 45.2% to 47.4% of patients aged 50 to 69, while only 18.2% of patients aged 90 to 95 years. Gleason's sum 7 had 45.5% of the 46-49 age group, also in the 55-59 and 65-69 years age groups, the sum 7 had 26.3% and 28.7% of the patients, respectively. In the age group 46-49 none of the patients had Gleason's sum 8, while in the 85-89 and 90-95 age groups there were 17.5% or 27.3% of the patients, respectively. Gleason 9 had 9.1% patients of the 46-49 and 90-95 age groups, while in the age group 80-84 there were 9.0% of the patients. Gleason's sum 10 had 3.4% of patients in the age group 80-84 and 5.0% of patients in the 85-89 age group. All other age groups had values below 0.8%. In our study, 20.9% of patients older than 75 years and 13.3% of patients under 75 years of age had Gleason's sum of 8 or more. 58.5% to 63.6% of patients aged 55 to 69 years belonged in the Prognostic Group 1. While only 27.3% of patients aged 90 to 95 belonged in the Prognostic Group 1. In the Prognostic Group 2 belonged 45.5% of the age group 46-49 and only 16.3% of the patients aged 80 to 84 years. The youngest group had no patients in the Prognostic Group 3, while the age group 85-89 had 15.0%. Prognostic Group 4 also did not have any patients from the youngest group, while the 85-89 and 90-95 age groups had 17.5% and 27.3%, respectively. In the Prognostic group 5 belonged 9.1% of patients aged 46 to 49 and 90 to 95 years.
Conclusions: Rates of Gleason's numbers 8, 9 and 10 increased with the patient's age. Older patients are more often alocated in the groups with worse prognosis. Also, patients under the age of 55 have a higher incidence of Gleason's sum 8 and 9. |