Jornal Brasileiro de Patologia e Medicina Laboratorial (Feb 2010)
Relação entre escore de Gleason e fatores prognósticos no adenocarcinoma acinar de próstata The relation between Gleason score and prognostic factors in acinar adenocarcinoma of prostate
Abstract
INTRODUÇÃO: O adenocarcinoma de próstata corresponde a uma das neoplasias malignas mais frequentes em homens, comprometendo principalmente da sexta a oitava décadas. Algumas características histopatológicas do tumor, como grau de diferenciação, invasão capsular e escore de Gleason, podem ser correlacionadas com o prognóstico da doença. OBJETIVOS: Estimar a associação entre o escore de Gleason e fatores prognósticos em casos de adenocarcinoma prostático. MATERIAL E MÉTODO: O estudo avaliou 118 espécimes de prostatectomia radical provenientes do Laboratório de Patologia da ULBRA entre 2003 e 2008. Em cada caso foram determinados os seguintes dados: idade, lateralidade, estadiamento, escore total e padrões primário e secundário de Gleason, grau de diferenciação, presença de invasão capsular, angiolinfática e perineural e extensão extraprostática. Foram usados os testes do qui-quadrado e o teste exato de Fischer para verificar a associação entre as variáveis, considerando um nível de significância menor que 5%. RESULTADOS: A idade média correspondeu a 63,86 anos. Observou-se a predominância do escore 6 de Gleason (55 casos - 46,61%), de bilateralidade (72 casos - 61,02%) e do estádio T2c (57 casos - 48,31%). O escore de Gleason esteve associado a idade (0,001), lateralidade (p INTRODUCTION: The prostate adenocarcinoma corresponds to one of the most frequent malignant neoplasias affecting 60 to 80 year old men. Some histopathological characteristics of the tumor, such as degree of differentiation, capsular invasion and Gleason score, may be correlated with the prognosis of the disease. OBJECTIVES: To assess the association of Gleason score and prognostic factors in cases of prostatic adenocarcinoma. MATERIAL AND METHOD: The study evaluated one hundred and eighteen specimens of radical prostatectomy from the laboratory of pathology of ULBRA between 2003 and 2008. In each case, the following data were recorded: age, laterality, staging, total score, primary and secondary patterns of Gleason, degree of differentiation, presence of capsular, angiolymphatic and perineural invasion and extraprostatic extension. Chi-square test and Fischer's exact test with significance < 5% were used. RESULTS: The mean age was 63.86. There was a prevalence of Gleason score 6 (55 cases - 46.61%), bilaterality (72 cases - 61.02%) and staging T2c (57 cases - 48.31%). Gleason score was associated with age (0.001), laterality (p < 0.001), capsular invasion (p < 0.005), angiolymphatic invasion (p < 0.001), perineural invasion (p < 0.05), extraprostatic invasion (p < 0.001) and staging (0.001). There was a significant association among capsular invasion, age (p < 0.01) and perineural invasion (p < 0.001). CONCLUSION: In prostate adenocarcinomas, the determination of Gleason score corresponds to one of the main histological factors to be described, showing significant relation with other anatomopathological criteria, such as extension, perineural and angiolymphatic invasion and staging.
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