Extended 12-core prostate biopsy increases both the detection of prostate cancer and the accuracy of Gleason score
Extended 12-core prostate biopsy increases both the detection of prostate cancer and the accuracy of Gleason score
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DOI：
10.1016/j.eururo.2005.08.013
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发表时间：
2006-01-01
期刊：
影响因子：
23.4
通讯作者：
Khedr, MM
中科院分区：
文献类型：
--
作者：
Elabbady, AA;Khedr, MM
目的：探讨延长12芯前列腺活检在提高前列腺癌检出率和提高Gleason评分准确性方面的作用。方法：本研究纳入113例经trus引导的外侧六分仪活检患者（I组）和176例经扩展12核活检患者（II组）。前列腺活检的纳入标准是血清PSA水平升高（> 3.0 ng/ml）和/或可疑的直肠指检（DRE）。结果：两组患者临床特征相似。ⅰ组28例（24.8%），ⅱ组64例（36.4%），chi(2) = 4.26, p = 0.039。在I组癌症患者中，14例接受根治性前列腺切除术（RP）治疗。针刺和前列腺切除术标本的Gleason和中位值分别为6（范围3-8）和7（范围5-9）。有7例（50%）患者活检和前列腺切除术的Gleason sum值一致，而活检的Gleason sum值较低的有7例（50%）。在II组癌症患者中，27例接受RP治疗。针刺和前列腺切除术标本的Gleason sum的中位数和范围相同（中位数6，范围4-9）。23例（85.2%）患者活检标本与前列腺切除术标本吻合，4例（14.8%）患者活检标本低于前列腺切除术标本。II组活检标本与前列腺切除术标本的一致性（82.5%）显著高于I组（50%），Fisher精确检验，p = 0.026。结论：延长12芯前列腺活检可显著提高前列腺癌的检出率和活检Gleason评分的准确性。(c) 2005 Elsevier B.V.版权所有
Objective: To evaluate the effect of extended 12-core prostate biopsy in improving the detection rate of prostate cancer and increasing the accuracy of Gleason score.Methods: This study included 113 patients who underwent TRUS-guided lateral sextant biopsy (group I) and 176 patients who underwent extended 12-core biopsy (group II). Inclusion criteria for prostate biopsy were elevated serum PSA levels (> 3.0 ng/ml) and/or suspicious digital rectal examination (DRE).Results: Clinical characteristics were similar in both groups. Cancer was detected in 28 (24.8%) and 64 (36.4%) patients in group I and II respect tively, chi(2) = 4.26, p = 0.039. Among patients with cancer in group I, 14 were treated by radical prostatectomy (RP). The median Gleason sum was 6 (range 3-8) and 7 (range 5-9) for needle and prostatectomy specimens respectively. There was an agreement between the biopsy and prostatectomy Gleason sum in 7 (50%) patients while the biopsy Gleason sum was lower in 7 (50%) cases. Among patients with cancer in group II, 27 were treated by RP. The median and the range of Gleason sum was the same for needle and prostatectomy specimen (median 6, range 4-9). There was an agreement between the biopsy and prostatectomy specimen in 23 (85.2%) patients while the biopsy sum was lower than prostatectomy in 4 (14.8%) patients. The agreement between the biopsy and prostatectomy specimen was significantly higher in group II (82.5%) than group I (50%), Fisher's Exact Test, p = 0.026.Conclusion: Extended 12-core prostate biopsy significantly increases both the detection rate of prostate cancer and the accuracy of biopsy Gleason score. (c) 2005 Elsevier B.V. All rights reserved.