Prostat kanserinde de-ritis oranının patolojik sonuçları öngörmede önemi
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışma, prostat kanseri tanısıyla radikal prostatektomi yapılan hastalarda operasyon öncesi bakılan De Ritis oranının (serum Aspartat Transaminaz (AST)/Alanin Transaminaz (ALT)) ameliyat sonrası ISUP-GG (International Society of Urological Pathology Grade Group) derece yükselmesi (upgrade) ve patolojik sonuçları öngörmedeki etkinliği araştırıldı. Gereç ve Yöntem: Çalışmamızda 2012-2022 yılları arasında lokalize prostat kanseri nedeniyle radikal prostatektomi yapılan 152 hasta retrospektif olarak incelendi. Hastaların operasyon öncesi 1 aylık süre içerisinde bakılan serum AST ve ALT değerleri çalışmaya alındı. Hastaların yaşı, preoperatif tümör karakteristikleri (biyopsi öncesi PSA, prostat volümü, PSA dansitesi, biyopsi ISUP- GG, maksimum biyopsi tümör volümü) ve prostatektomi patolojik özellikleri (ISUP-GG, patolojik tümör evresi, lenf nodu tutulumu, seminal vezikül invazyonu ve cerrahi sınır durumu) değerlendirildi. Bulgular: Radikal prostatektomi sonrası ISUP upgrade saptanan grupta De Ritis oranı ortalaması upgrade saptanmayan gruba göre daha düşük saptandı (1,14±0,28 karşı 1,10±0,27, p=0.38). Upgrade tahmin etmek için yapılan ROC eğri analizi sonucunda optimal De Ritis oranı eşiği 1.22 olarak hesaplandı. Düşük De Ritis oranı olan grupta upgrade görülme oranı istatistiksel olarak anlamlı şekilde daha yüksek saptandı (%51'e karşı %34, p=0.05). Düşük De Ritis oranı olan hastalarda, radikal prostatektomi sonrası patolojik T3, seminal vezikül invazyonu ve lenf nodu invazyonu oranları istatistiksel olarak anlamlı olmasa da daha yüksek saptandı (p değerleri sırasıyla 0.68, 0.50 ve 0.39). Sonuçlar: Çalışmamız sonucunda düşük De Ritis oranı ile radikal prostatektomi sonrası ISUP upgrade ve olumsuz patolojik özellikler (T3, lenf nodu tutulumu, seminal vezikül invazyonu) arasında ilişkili olabileceğini düşündürmektedir.
Objective: The usefulness of the preoperative De Ritis ratio in predicting post-operative ISUP-GG (International Society of Urological Pathology Grade Group) upgrading and pathological outcomes was examined in this study. Materials and Methods: In our study, 152 patients who underwent radical prostatectomy for localized prostate cancer between 2012 and 2022 were retrospectively analyzed. Blood samples including AST and ALT were collected a month before surgery. Age, preoperative tumor characteristics, such as pre-biopsy PSA, prostate volume, PSA density, biopsy ISUP-GG, maximum biopsy tumour volume, and prostatectomy pathological features, such as ISUP-GG, pathological tumour stage, lymph node involvement, seminal vesicle invasion, and surgical margin status, were assessed. Results: The mean De Ritis ratio was found to be lower in the group with ISUP upgrading than in the group without upgrade following radical prostatectomy (1,14±0,28 versus 1,10±0,27, p=0.38). The optimal cutoff value for the De Ritis ratio was 1.22 as a result of the ROC curve study to predict the upgrade. The group with a low De Ritis ratio had a greater rate of upgrading, which was statistically significant (51% versus 34%, p=0.05). Pathological T3, seminal vesicle invasion, and lymph node invasion rates were observed to be higher in patients with low De Ritis ratio following radical prostatectomy, although this finding was not statistically significant (p values of 0.68, 0.50, and 0.39, respectively). Conclusions: According to our research, a low De Ritis ratio may be linked to ISUP upgrading and unfavorable pathological traits (T3, lymph node involvement, and seminal vesicle invasion) following radical prostatectomy.
Objective: The usefulness of the preoperative De Ritis ratio in predicting post-operative ISUP-GG (International Society of Urological Pathology Grade Group) upgrading and pathological outcomes was examined in this study. Materials and Methods: In our study, 152 patients who underwent radical prostatectomy for localized prostate cancer between 2012 and 2022 were retrospectively analyzed. Blood samples including AST and ALT were collected a month before surgery. Age, preoperative tumor characteristics, such as pre-biopsy PSA, prostate volume, PSA density, biopsy ISUP-GG, maximum biopsy tumour volume, and prostatectomy pathological features, such as ISUP-GG, pathological tumour stage, lymph node involvement, seminal vesicle invasion, and surgical margin status, were assessed. Results: The mean De Ritis ratio was found to be lower in the group with ISUP upgrading than in the group without upgrade following radical prostatectomy (1,14±0,28 versus 1,10±0,27, p=0.38). The optimal cutoff value for the De Ritis ratio was 1.22 as a result of the ROC curve study to predict the upgrade. The group with a low De Ritis ratio had a greater rate of upgrading, which was statistically significant (51% versus 34%, p=0.05). Pathological T3, seminal vesicle invasion, and lymph node invasion rates were observed to be higher in patients with low De Ritis ratio following radical prostatectomy, although this finding was not statistically significant (p values of 0.68, 0.50, and 0.39, respectively). Conclusions: According to our research, a low De Ritis ratio may be linked to ISUP upgrading and unfavorable pathological traits (T3, lymph node involvement, and seminal vesicle invasion) following radical prostatectomy.
Açıklama
Anahtar Kelimeler
Üroloji, Urology
