Serum Psa Level and Gleason Scores of Needle Biopsy Specimens Predict the Postoperative Pathologic Grade of Prostate Cancer

Objective: To investigate the correlation between postoperative pathologic grade of prostate cancer (PC) and preoperative serum PSA as well as grade of biopsy specimens. Methods: The serum PSA and preoperative and postoperative Gleason scores of PC were retrospectively analyzed in 75 patients. Correlation between serum PSA and postoperative Gleason score was evaluated, and the Gleason score before surgery was compared with that after surgery with Wilcoxon signed rank test. Results: The PSA before operation was 4~230 ng/mL (mean: 33.5 ng/mL) and the Gleason score of biopsy specimen was 2~9 (mean: 4.4). The Gleason score of specimens following radical prostatectomy was 2~10 (mean: 4.8). Preoperative serum PSA was positively correlated with postoperative Gleason score (rs=0.279, P=0.015). Gleason score of biopsy specimens was significantly lower than that after radical prostatectomy (P=0.011). Conclusions: High PSA level is associated with high Gleason score of specimens after radical prostatectomy. Pre-operative pathological examination of biopsy specimens may under-grade the PC. Re-biopsy is recommended to avoid underestimation of PC