Individualized prostate biopsy strategy for Chinese patients with different prostate-specific antigen levels
Individualized prostate biopsy strategy for Chinese patients with different prostate-specific antigen levels
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DOI：
10.1111/j.1745-7262.2008.00345.x
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发表时间：
2008-03-01
影响因子：
2.9
通讯作者：
Wang, Bo-Hua
中科院分区：
文献类型：
--
作者：
Dai, Bo;Ye, Ding-Wei;Wang, Bo-Hua
目的：评估中国疑似前列腺癌患者的最佳个体化前列腺活检策略。方法：本研究纳入了 221 名首次接受经直肠超声引导前列腺活检的中国患者。所有患者均接受相同的 10 芯活检方案。除了 Hodge 六分仪技术外，还从双侧周边区域的基底和中部区域获得了另外四个活检组织。评估了 10 核和六分仪策略在不同前列腺特异性抗原 (PSA) 水平患者癌症检测中的差异。还分析了前列腺癌患者的 PSA 水平、阳性活检核心数量与器官局限性癌症发生率之间的关系。结果：221名患者的前列腺癌总体检出率为40.7%。 10 核策略将我们患者的癌症检出率提高了 6.67% (6/90) (P < 0.05)。当患者PSA水平从0-20 ng/mL增加到20.1-50 ng/mL和> 50 ng/mL时，癌症检出率显着下降（P < 0.01）。前列腺癌患者的活检阳性核心数量随着患者PSA水平的升高而显着增加（P < 0.01）。随着患者PSA水平的升高，器官局限性前列腺癌的发生率显着降低（P < 0.01）。结论：对于 PSA 50 ng/mL 的中国患者，推荐采用扩展 10 核策略。对于PSA在20.1 ng/mL~50 ng/mL的患者，预期寿命≥10年的患者应采用10核策略，预期寿命<10年的患者应采用六分仪策略。
Aim: To evaluate the best individualized prostate biopsy strategies for Chinese patients with suspected prostate cancer. Methods: The present study included 221 Chinese patients who underwent transrectal ultrasound guided prostate biopsies for the first time. All patients underwent the same 10-core biopsy protocol. In addition to the Hodge sextant technique, four more biopsies were obtained from the base and middle regions of bilateral peripheral zones. The differences between 10-core and sextant strategies in cancer detection among patients with different prostate specific anitgen (PSA) levels were evaluated. The relationship between PSA level, number of positive biopsy cores and organ-confined cancer rate in prostate cancer patients was also analyzed. Results: The overall prostate cancer detection rate was 40.7% in the 221 patients. The 10-core strategy increased cancer detection by 6.67% (6/90) in our patients (P < 0.05). The increased cancer detection rates decreased significantly when the patient PSA level increased from 0-20 ng/mL to 20.1-50 ng/mL and > 50 ng/mL (P < 0.01). The number of positive biopsy cores in prostate cancer patients increased significantly with increasing patient PSA level (P < 0.01). The rate of organ-confined prostate cancer decreased significantly with increasing patient PSA level (P < 0.01). Conclusion: The extended 10-core strategy is recommended for Chinese patients with PSA 50 ng/mL. For patients with PSA ranging from 20.1 ng/mL to 50 ng/mL, the 10-core strategy should be applied in patients with life expectancy >= 10 years and the sextant strategy should be applied in those with life expectancy < 10 years.