The relationship of prostate gland volume to extended needle biopsy on prostate cancer detection
The relationship of prostate gland volume to extended needle biopsy on prostate cancer detection
复制标题
DOI：
10.1016/s0022-5347(05)64052-9
复制
发表时间：
2003-01-01
影响因子：
6.6
通讯作者：
Olumi, AF
中科院分区：
文献类型：
--
作者：
Ung, JO;San Francisco, IF;Olumi, AF
目的：探讨前列腺体积与针吸活检检出癌的关系，以及增加针芯数对前列腺大腺针吸活检抽样误差的影响。材料和方法：1995年1月至2001年8月，连续750例患者接受经直肠超声引导下前列腺穿刺活检术。前列腺体积分为四分位数(13~34，34.1~45，45.1对，64.1~244cc)。对年龄、前列腺特异性抗原和活检指征进行多因素分析，以确定前列腺癌诊断的影响因素。结果：前列腺癌患者较非前列腺癌患者年龄大(p=0.0035)，前列腺特异性抗原水平高(p=0.0002)。前列腺癌的发现率随着前列腺体积的增大而降低(p=0.0074)。每增加一个活检芯数的检测OR为0.99(95%CI为0.93，1.06)，提示增加活检芯数并不会增加前列腺癌的检出率。多变量分析显示，随着活检芯数的增加，前列腺较大的患者的癌症检测率相同或可能更低。前列腺体积较大的患者年龄较大(p
Purpose: We investigated the relationship between prostate volume and cancer detection by needle biopsy, and determined the effect of an increased number of cores on the sampling error of needle biopsy on large prostate glands.Materials and Methods: The study cohort included 750 consecutive patients who underwent first time transrectal ultrasound guided prostate needle biopsy from January 1995 to August 2001. Prostate volumes were divided into quartiles (13 to 34, 34.1 to 45, 45.1 to 64 and 64.1 to 244 cc). Multivariate analysis controlling for age, prostate specific antigen (PSA) and biopsy indication was performed to determine the effect of the number of cores and prostate volume on prostate cancer detection.Results: Patients diagnosed with prostate cancer were older (p = 0.0035) and had higher PSA levels (p = 0.0002) than those with no cancer on biopsy. Decreasing cancer detection rates were seen with increasing prostate volume (p = 0.0074). The OR of detection for each additional core was 0.99 (95% CI 0.93, 1.06), suggesting that increasing the number of biopsy cores did not increase the rate of prostate cancer detection. Multivariate analysis revealed that patients with larger prostates had the same, or possibly lower, cancer detection rate as the number of biopsy cores was increased. Patients with larger prostates were older (p