Repeat prostate biopsy-when, where, and how
Repeat prostate biopsy-when, where, and how
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DOI：
10.1016/j.urolonc.2008.10.029
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发表时间：
2009-05-01
影响因子：
2.7
通讯作者：
Presti, Joseph C., Jr.
中科院分区：
文献类型：
--
作者：
Presti, Joseph C., Jr.
前列腺活检阴性后PSA水平持续升高或升高的患者对泌尿科医生和患者来说都是一种压力。这将是对接受重复活检的患者的适应症和技术的简要回顾。对于既往活检阴性的患者，评估初始活检的充分性非常重要。F/T PSA是目前在重复活检中预测癌症最有用的标志物，尽管新的标志物如PCA 3是有希望的。重复活检应包括至少14个芯，初次活检推荐的12个芯和从右前尖和左前尖获得的2个额外芯。对于重复活检未能识别癌症的患者，但临床怀疑仍然很高，考虑饱和活检方法似乎是必要的。(C)2009 Elsevier Inc. All rights reserved.
Patients who have a persistently elevated or a rising PSA level following a prior negative prostate biopsy can be a stressful situation for both the urologist and the patient. This will be a brief review of the indications and techniques in patients undergoing a repeat biopsy. In patients with a prior negative biopsy, assessing the adequacy of the initial biopsy is important. F/T PSA is currently the most useful marker in predicting cancer on repeat biopsy although newer markers, such as PCA3, are promising. Repeat biopsies should include a minimum of 14 cores, the 12 cores recommended for an initial biopsy and 2 additional cores obtained form the right and left anterior apex. In patients for whom repeat biopsies fail to identify cancer, yet the clinical suspicion remains high, consideration for a saturation biopsy approach seems warranted. (C) 2009 Elsevier Inc. All rights reserved.