Differences in tumor core distribution between palpable and nonpalpable prostate tumors in patients diagnosed using extensive transperineal ultrasound-guided template prostate biopsy
Differences in tumor core distribution between palpable and nonpalpable prostate tumors in patients diagnosed using extensive transperineal ultrasound-guided template prostate biopsy
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DOI：
10.1002/cncr.21020
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发表时间：
2005-05-01
期刊：
影响因子：
6.2
通讯作者：
Shinohara, N
中科院分区：
文献类型：
--
作者：
Demura, T;Hioka, T;Shinohara, N
背景作者进行了广泛的经会阴超声引导模板前列腺活检，以调查癌核心分布。在2000年8月至2004年5月期间，371名男性接受了模板活检。312例患者以前未接受过活检（第一组），59例患者以前接受过经直肠六分仪活检（重复组）。在第一组的312名患者中，236名患者的直肠指检（DRE）结果正常（DRE-第一组），76名患者的DRE异常（DRE+第一组）。从整个前列腺中平均采集20.1个活检芯（范围，9-38个芯）。距离前列腺直肠面> 2.0 cm的区域定义为前列腺前部区域，其余区域定义为前列腺后部区域。在DRE-第一组中，前部区域的癌核心率（肿瘤核心数/活检核心数）（7.2%）与后部区域的癌核心率（7.3%）没有差异（P = 0.9635）。而DRE+第一组，后区癌核心率（22.0%）高于前区（13.2%）（P < 0.0001）。在重复组中，后部区域的癌核心率（3.1%）显著低于前部区域（7.2%）（P = 0.0008）。目前的研究结果表明，不可触及的前列腺癌均匀分布在整个前列腺，虽然可触及的癌主要分布在后部区域和许多肿瘤病灶在前部区域可能会错过了经直肠的六分仪活检。需要对根治性直肠癌切除术标本进行检查以证明这些结果。(c)2005年美国癌症协会。
BACKGROUND. The authors performed extensive transperineal ultrasound-guided template prostate biopsies to investigate carcinoma core distribution.METHODS. Between August 2000 and May 2004, 371 men underwent template biopsies. Three hundred twelve patients had not undergone a previous biopsy (first group) and 59 bad undergone previous transrectal sextant biopsies (repeat group). Of the 312 patients in the first group, 236 had normal digital rectal examination (DRE) findings (DRE- first group) and 76 patients had an abnormal DRE (DRE+ first group). A mean of 20.1 biopsy cores (range, 9-38 cores) was taken from the entire prostate. The region > 2.0 cm from the rectal face of the prostate was defined as the anterior region and the remaining area was defined as the posterior region.RESULTS. in the DRE- first group, the carcinoma core rate (number of tumor cores/number of biopsy cores) in the anterior region (7.2%) did not differ from that of the posterior region (7.3%) (P = 0.9635). However, in the DRE+ first group, the carcinoma core rate in the posterior region (22.0%) was found to be higher than in the anterior region (13.2%) (P < 0.0001). In the repeat group, the carcinoma core rate in the posterior region (3.1%) was significantly (P = 0.0008) lower than that exhibited in the anterior region (7.2%).CONCLUSIONS. The results of the current study suggest that nonpalpable prostate carcinoma is distributed equally within the entire prostate, although palpable carcinoma is distributed mainly in the posterior region and many of the tumor foci in the anterior region may be missed by a transrectal sextant biopsy. The examination of radical prostatectomy specimens is required to prove these results. (c) 2005 American Cancer Society.