REPEAT PROSTATE NEEDLE-BIOPSY - WHO NEEDS IT
REPEAT PROSTATE NEEDLE-BIOPSY - WHO NEEDS IT
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DOI：
10.1016/s0022-5347(01)67444-5
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发表时间：
1995-05-01
影响因子：
6.6
通讯作者：
BRAWER, MK
中科院分区：
文献类型：
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作者：
ELLIS, WJ;BRAWER, MK
经直肠超声引导下六分活检后再次前列腺穿刺活检的指征尚未确定。我们检查了100个没有诊断为恶性肿瘤的六分前列腺穿刺活检，并重复检查。在20例重复活检中检出癌（20%）。基于初始活检结果的分层显示，69例无前列腺上皮内瘤变或异型性的病例中有10例（14.5%）为癌，17例非异型性病例中有5例（29.4%），5例（100%）为II级或III级前列腺上皮内瘤变，9例I级前列腺上皮内瘤变中有0例。前列腺特异性抗原（PSA）水平和PSA速度的检查没有提供统计学显著分层，可能是由于这些参数的广泛差异和样本量小。我们的结论是，诊断为腺性前列腺增生，或II级或III级前列腺上皮内瘤变的患者在初始活检是浸润性癌的高风险，并应进行重复前列腺穿刺活检。快速升高的血清PSA水平或直肠指检异常也可能提示初次活检未发现的癌。
The indications for repeat prostate needle biopsy after a transrectal ultrasound guided sextant biopsy are not defined. We examined 100 sextant prostate needle biopsies without a diagnosis of malignancy, which were repeated. Carcinoma was detected in 20 repeat biopsies (20%). Stratification based on initial biopsy result revealed carcinoma in 10 of 69 cases (14.5%) without prostatic intraepithelial neoplasia or atypia, 5 of 17 (29.4%) with atypia, 5 of 5 (100%) with grade II or III prostatic intraepithelial neoplasia and 0 of 9 with grade I prostatic intraepithelial neoplasia. Examination of prostate specific antigen (PSA) levels and PSA velocity did not provide statistically significant stratification, perhaps due to the wide variance in these parameters and the small sample size. We conclude that patients with a diagnosis of glandular atypia, or grade II or III prostatic intraepithelial neoplasia on initial biopsy are at high risk for invasive carcinoma and should undergo repeat prostate needle biopsy. A rapidly increasing serum PSA level or grossly abnormal digital rectal examination may also indicate carcinoma not discovered on initial biopsy.