Saturation prostate needle biopsy and prostate cancer detection at initial and repeat evaluation
Saturation prostate needle biopsy and prostate cancer detection at initial and repeat evaluation
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DOI：
10.1016/j.urology.2007.07.068
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发表时间：
2007-12-01
期刊：
影响因子：
2.1
通讯作者：
Aragona, Francesco
中科院分区：
文献类型：
--
作者：
Pepe, Pietro;Aragona, Francesco
为了评估前列腺癌（PCa）的发病率在患者谁经历了饱和前列腺活检（SPBx）作为主要biopsization.METHODS或在案件rebiopsization.METHODS我们评估了189例（中位年龄60.3岁）提交经直肠超声引导SPBx（范围，24至37核心;中位数，29）。在98名男性中，SPBx作为初次手术进行，75名作为第二次手术，16名作为第三次活检集。活检适应症为：DRE异常;总蛋白特异性抗原（PSA）（tPSA）大于10 ng/mL; tPSA等于4至10、2.6至3.9、小于或等于2.5 ng/mL;和游离PSA百分比（%-fPSA）分别为25%或更低、20%或更低和15%或更低。根据相同的方案，将使用SPBx作为初始活检的PCa检测与分别接受12和18芯活检的256和116例患者的PCa检测进行回顾性比较。75例患者提交的SPBx作为第二次活检集的结果进行了回顾性比较，发现在73名男子谁经历了18芯re-biopsiz. Results的PCa检出率与SPBx作为主要活检是46.9%，大于12芯活检（39.8%; P = 0.3），但低于18芯活检（49%; P = 0.6）。在第二次和第三次活检的情况下，使用SPBx与18芯活检相比，PCa的发生率分别为22%和10.9%（P = 0.003），6.2%和0%。肿瘤微灶的发生率在第一次活检时为34.7%，在第二次活检时为45.5%。在所有接受根治性直肠癌切除术并经活检诊断为肿瘤性微病灶的患者中，pTNM显示有临床意义的癌症（肿瘤体积大于0.5mL或Gleason评分为6或更高）。结论：与18芯方案相比，SPBx作为原发性活检并不增加PCa的检出率;在再次活检的情况下，SPBx是推荐的方法，因为与12芯或18芯活检组相比，PCa检出率增加了一倍。
OBJECTIVES To evaluate the incidence of prostate cancer (PCa) in patients who underwent a saturation prostate biopsy (SPBx) as primary biopsy or in case of rebiopsy.METHODS We assessed 189 patients (median age 60.3 years) submitted to a transrectal ultrasound-guided SPBx (range, 24 to 37 cores; median, 29). In 98 men the SPBx was performed as the primary procedure, in 75 as the second, and in 16 as the third biopsy set. Indications for biopsy were: abnormal DRE; total protate specific antigen (PSA) (tPSA) greater than 10 ng/mL; tPSA equal to 4 to 10, 2.6 to 3.9, less than or equal to 2.5 ng/mL; and percent free PSA (%-fPSA) 25% or less, 20% or less, and 15% or less, respectively. The PCa detection using an SPBx as initial biopsy was compared retrospectively with that found in 256 and 116 patients who underwent 12- and 18-core biopsy, respectively, according to the same protocol. The results obtained in 75 patients Submitted to an SPBx as the second biopsy set were compared retrospectively with those found in 73 men who underwent an 18-core re-biopsy.RESULTS The PCa detection rate with SPBx as primary biopsy was 46.9%, greater than the 12-core biopsy (39.8%; P = 0.3) but lower than the 18-core biopsy (49%; P = 0.6). In the case of second and third biopsy, the incidence of PCa when using an SPBx compared with 18-core biopsy was 22% versus 10.9% (P = 0.003) and 6.2% versus 0%, respectively. The incidence of neoplastic microfoci was 34.7% at first and 45.5% at second biopsy set. In all patients who underwent a radical prostatectomy with a bioptic diagnosis of neoplastic microfocus, the pTNM revealed a clinically significant cancer (tumor volume greater than 0.5 mL or Gleason score of 6 or higher).CONCLUSIONS As primary biopsy, SPBx does not increase the PCa detection rate compared with an 18-core scheme; in the case of rebiopsy, the SPBx is a recommended method as the PCa detection rate is doubled compared with 12- or 18-core biopsy sets.