Analysis of repeated 24-core saturation prostate biopsy: Inverse association between asymptomatic histological inflammation and prostate cancer detection.
Analysis of repeated 24-core saturation prostate biopsy: Inverse association between asymptomatic histological inflammation and prostate cancer detection.
复制标题
重复 24 芯饱和前列腺活检分析：无症状组织学炎症与前列腺癌检测之间的负相关。
DOI：
10.3892/ol.2016.4693
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发表时间：
2016
期刊：
影响因子：
2.9
通讯作者：
H. Fuse
中科院分区：
文献类型：
--
作者：
Tomonori Kato;A. Komiya;A. Morii;Hiroaki Iida;Takatoshi Ito;H. Fuse
饱和前列腺活检方案已经发展到提高前列腺癌（PCa）的检出率，特别是在重复活检的设置。本研究试图阐明重复饱和活检中PCa检测与各种危险因素之间的关系。对78名日本患者进行回顾性分析，这些患者尽管既往前列腺活检呈阴性，但结果仍怀疑前列腺癌，并在富山大学医院（日本富山）连续接受了24核经会阴重复活检。78例患者中有16例（20.5%）经组织学证实为前列腺癌。单因素分析显示，前列腺特异性抗原（PSA）水平在重复活检中较高（P<0.01）， fPSA/tPSA比较低（P=0.04），前列腺总体积较小（P=0.01）， PSA密度高于良性前列腺疾病（BPD）患者（P<0.01）。BPD患者出现组织学炎症的频率高于PCa患者（P<0.01）。多变量分析显示，组织学炎症是重复活检中恶性病变存在的唯一独立预测因子（优势比，0.027；P=0.01）。必须考虑到炎症可能导致一些初始活检阴性的患者PSA升高，从而导致不必要的重复活检。
Saturation prostate biopsy protocols have been developed to improve the prostate cancer (PCa) detection rate, particularly in the setting of repeat biopsies. The present study attempted to clarify the association between PCa detection and various risk factors in repeat saturation biopsies. A retrospective analysis was conducted on 78 Japanese patients for whom findings had caused suspicion of PCa despite previous negative prostate biopsies, and who consecutively underwent a 24-core transperineal repeat biopsy at Toyama University Hospital (Toyama, Japan). PCa was confirmed histologically in 16 of the 78 patients (20.5%). A univariate analysis revealed that the prostate-specific antigen (PSA) level at repeat biopsy was higher (P<0.01), the fPSA/tPSA ratio was lower (P=0.04), the total prostate volume was smaller (P=0.01) and the PSA density was higher (P<0.01) in PCa patients than in patients with benign prostatic disease (BPD). Histological inflammation was more frequently observed in BPD patients than in PCa patients (P<0.01). A multivariate analysis revealed that histological inflammation was the only independent predictor of the presence of a malignant lesion on repeat biopsy (odds ratio, 0.027; P=0.01). It must be considered that inflammation may cause a PSA increase in some patients with a negative initial biopsy, leading to unnecessary repeat biopsy.