Location and Pathological Characteristics of Cancers in Radical Prostatectomy Specimens Identified by Transperineal Biopsy Compared to Transrectal Biopsy
Location and Pathological Characteristics of Cancers in Radical Prostatectomy Specimens Identified by Transperineal Biopsy Compared to Transrectal Biopsy
复制标题
DOI：
10.1016/j.juro.2012.05.006
复制
发表时间：
2012-09-01
影响因子：
6.6
通讯作者：
Stricker, Phillip
中科院分区：
文献类型：
--
作者：
Hossack, Tania;Patel, Manish I.;Stricker, Phillip
目的：前列腺前叶肿瘤估计占前列腺癌的20%。目前的数据表明，经会阴活检是更可靠的，比经直肠活检，以确定这些肿瘤。如果正确的话，这种上级的可靠性将导致经会阴活检发现前部肿瘤的比例增加。材料和方法：回顾性分析根治性乳腺癌切除术后的组织病理学资料。根据原发性经会阴或经直肠活检作为用于识别初始癌症的方式对患者进行分组。分组后，肿瘤的位置和大小进行了记录，从而，前部肿瘤的比例determined.Results：共1,132（414经会阴和718经直肠）直肠切除标本进行了检查。经会阴和经直肠方法的总体平均肿瘤大小（1.8和2.0 cm（3））、分期（pT 2 63.3%和61%）和显著性（5.1%和5.1%）相似。然而，与经直肠方法相比，经会阴方法与更多的前部肿瘤相关（16.2% vs 12%，p = 0.046），并且识别出的肿瘤尺寸更小（1.4 vs 2.1 cm（3），p = 0.03），分期更低（囊外扩展13% vs 28%，p = 0.03）。pT 3阳性手术切缘率为前与其他tumors.Conclusions：总的经直肠和经会阴活检确定的癌症是相似的大小，阶段和意义分别为69%和34.9%。然而，与经直肠活检相比，经会阴活检检测到的前部肿瘤比例更高（16.2% vs 12%），并且在较小的尺寸（1.4 vs 2.1 cm（3））和分期（囊外扩展13% vs 28%）下识别它们。早期识别前部肿瘤很重要，因为前部pT 3病变的手术切缘阳性率明显较高。
Purpose: Anterior tumors are estimated to constitute 20% of prostate cancers. Current data indicate that transperineal biopsy is more reliable than transrectal biopsy in identifying these tumors. If correct, this superior reliability should result in an increased proportion of anterior tumors identified by transperineal biopsy. We investigated this hypothesis with reference to prostatectomy specimens.Materials and Methods: Radical prostatectomy histopathology records were retrospectively examined. Patients were grouped based on primary transperineal or transrectal biopsy as the modality used to identify the initial cancer. After grouping, tumor location and size were recorded and, thus, the proportion of anterior tumors was determined.Results: A total of 1,132 (414 transperineal and 718 transrectal) prostatectomy specimens were examined. Overall mean tumor size (1.8 and 2.0 cm(3)), stage (pT2 63.3% and 61%) and significance (5.1% and 5.1%) for the transperineal and transrectal methods were similar. However, the transperineal method was associated with proportionally more anterior tumors (16.2% vs 12%, p = 0.046), and identified them at a smaller size (1.4 vs 2.1 cm(3), p = 0.03) and lower stage (extracapsular extension 13% vs 28%, p = 0.03) compared to the transrectal method. The pT3 positive surgical margin rate for anterior vs other tumors was 69% vs 34.9%, respectively.Conclusions: Overall transrectal and transperineal biopsy identify cancers that are similar in size, stage and significance. However, transperineal biopsy detected proportionally more anterior tumors (16.2% vs 12%), and identified them at a smaller size (1.4 vs 2.1 cm(3)) and stage (extracapsular extension 13% vs 28%) compared to transrectal biopsy. Identifying anterior tumors early is important because the positive surgical margin rate for anterior pT3 lesions is significantly higher.