The Changes in Gleason Score Between the Diagnostic Biopsy and Radical Prostatectomy Pathology

A total of 100 patients diagnosed with prostate cancer via transrectal ultrasound biopsies and who underwent radical prostatectomy were identified; patients were divided into three groups: downgrade, consistent, and upgrade. Forty-four (44%) patients had a Gleason score downgrade, twenty (20%) patients had a Gleason score upgrade, and thirty-six (36%) had a consistent Gleason score. The changes range from − 6 to 2, forty-seven (47%) patients had one grade jump between biopsy and radical surgery specimen, and seventeen (17%) had more than one grade jump. Gleason scores of 6 and 7 were the risk factor of upgrade (odds ratio = 27.844, 95% confidence interval, CI = 2.427–319.379, p = 0.008; and odds ratio = 14.391, 95% CI = 1.331–155.626, p = 0.028; respectively), and subgroup analysis indicated secondary Gleason grade = 3 was the risk factor of upgrade (odds ratio = 6.732, 95% CI = 1.059–42.804, p = 0.043); primary Gleason grade, age, prostate volume, and positive biopsy cores were not associated with Gleason score changes. Most prostate cancer biopsy patients had changes in their Gleason scores and histopathologic scores. For patients with risk factors for score changes, it was necessary to carefully evaluate and formulate optimal treatment methods, including surgical methods.