Extended peripheral zone biopsy schemes increase cancer detection rates and minimize variance in prostate specific antigen and age related cancer rates: Results of a community multi-practice study
Extended peripheral zone biopsy schemes increase cancer detection rates and minimize variance in prostate specific antigen and age related cancer rates: Results of a community multi-practice study
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DOI：
10.1016/s0022-5347(05)64051-7
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发表时间：
2003-01-01
影响因子：
6.6
通讯作者：
Veltri, RW
中科院分区：
文献类型：
--
作者：
Presti, JC;O'Dowd, GJ;Veltri, RW
目的：我们评估了年龄和前列腺特异性抗原（PSA）的影响，扩大系统活检计划检测前列腺癌和更好地表征这些肿瘤作为一个功能的患者年龄和PSA.Materials和方法：我们回顾性分析了2,299例连续患者进行首次系统活检的记录，由167个社区为基础的泌尿科医生。在所有患者中，共获得了12个外周区的系统活检。然后创建各种活检方案并计算癌症检测率。数据分析按患者年龄和PSA.Results分层：活检1,020例（44.4%）有癌症。检出率随患者年龄的增加而增加。年龄和PSA的增加与更大、更高级别的肿瘤相关。侧向活检和标准六分仪方案的心尖活检的总体和独特部位特异性癌症检出率最高。在PSA <7 ng的患者中，12个部位活检方案优于所有其他方案。/ ml.或更少的人，以及60岁或更年轻的人。年龄相关和PSA相关的检测率的变化是最大的标准六分仪计划和这种变异性降低延长活检schemes.Conclusions：这种多实践社区为基础的研究证实了不足的六分仪活检，并强调需要扩大外周区采样的前列腺的侧面。一般来说，患者年龄和PSA的增加与更大、更高级别的肿瘤相关。扩大活检方案最大限度地降低PSA和年龄相关的检出率。
Purpose: We assessed the impact of age and prostate specific antigen (PSA) on extended systematic biopsy schemes for detecting prostate carcinoma and better characterized these tumors as a function of patient age and PSA.Materials and Methods: We retrospectively reviewed the records of 2,299 consecutive patients who underwent initial systematic biopsy performed by 167 community based urologists. A total of 12 systematic biopsies of the peripheral zone were obtained in all patients. Various biopsy schemes were then created and cancer detection rates were calculated. Data analyses were stratified by patient age and PSA.Results: On biopsy 1,020 patients (44.4%) had cancer. Detection rates increased with increasing patient age. Increasing age and PSA were associated with larger, higher grade tumors. Overall and unique site specific cancer detection rates were highest for laterally directed biopsies and the apical biopsy of the standard sextant scheme. The 12 site biopsy scheme outperformed all other schemes in patients with PSA 7 ng./ml. or less and in those 60 years or younger. The variation in age related and PSA related detection rates was greatest for the standard sextant scheme and this variability decreased for extended biopsy schemes.Conclusions: This multi-practice community based study confirms the inadequacy of sextant biopsies and emphasizes the need for extended peripheral zone sampling of the lateral aspect of the prostate. Generally increasing patient age and PSA were associated with larger, higher grade tumors. Extended biopsy schemes minimize PSA and age related detection rates.