Abstract: Objective To explore the influencing factors of Gleason upgrade after radical prostatectomy on the basis of ISUP grouping in 2014 edition. Methods Clinical data of 189 patients who underwent radical prostatectomy in the First Affiliated Hospital of Xinjiang Medical University from 2016 to 2021 were retrospectively collected. According to whether Gleason after radical prostatectomy was higher than that during prostate puncture, 60 cases were divided into Gleason Grade Upgrading group （GGU group） and 129 cases were Gleason Grade non-Upgrading group （non-GGU group）. Univariate analysis and multivariate Logistic regression were performed to compare the data differences between the two groups. Results In univariate analysis, the length of punctured tumor tissue, Gleason major area score and Gleason minor area score were related to GGU （P<0.05）. After Logistic regression, the history of hypertension （OR=2.651）, Gleason major area score （OR=4.186）, tumor tissue length （OR=10.989） and positive rate of biopsy （OR=3.684） were related to GGU （P<0.05）. Conclusion History of hypertension, Gleason major area score of biopsy specimens, tumor tissue length in specimens, and positive biopsy rate may be associated with the risk of GGU.

Key words: radical prostatectomy, prostate cancer, Gleason scores, needle biopsy, pathology upgrade

摘要： 目的 在2014版ISUP分组的基础上,探讨前列腺癌根治术后Gleason升级的影响因素。方法 回顾性收集2016~2021年于新疆医科大学第一附属医院行前列腺癌根治术的临床数据189例,根据前列腺癌根治术后Gleason是否较前列腺穿刺时升高,分为Gleason升级组（GGU组）60例及Gleason非升级组（非GGU组）129例。单因素分析及多因素Logistic回归对比两组资料的差异。结果 单因素分析中穿刺肿瘤组织长度、Gleason主要区域评分及Gleason次要区域评分与GGU有关（P<0.05）,多因素Logistic回归后,高血压病史（OR=2.651）、Gleason主要区域评分（OR=4.186）、穿刺肿瘤组织长度（OR=10.989）及穿刺阳性率（OR=3.684）与GGU有关（P<0.05）。结论 高血压病史、穿刺标本Gleason主要区域评分、标本中肿瘤组织长度及穿刺阳性率可能与GGU的风险相关。

关键词: 前列腺癌根治术, 前列腺癌, Gleason评分, 穿刺活检, 病理升级