D'Amico A V, Whittington R, Malkowicz S B, Schultz D, Silver B, Henry L, Hurwitz M, Kaplan I, Beard C J, Tomaszewski J E, Renshaw A A, Wein A, Richie J P
Joint Center for Radiation Therapy, Harvard Medical School, Boston, Massachusetts 02215, USA.
Mol Urol. 2000 Fall;4(3):171-5;discussion 177.
The clinical utility of the percentage of positive prostate biopsies in predicting prostate specific antigen (PSA) outcome after radical prostatectomy (RP) or external-beam radiation therapy (EBRT) for men with PSA-detected or palpable prostate cancer is not established.
A Cox regression multivariable analysis was used to determine whether percent-positive prostate biopsies provided clinically relevant information about PSA outcome after RP in 960 men, while accounting for the previously established risk groups based on the pretreatment PSA concentration biopsy Gleason score, and the 1992 American Joint Commission on Cancer clinical T stage.
In the intermediate-risk group, 80% of the patients (stage T(2b) or biopsy Gleason 7 or PSA 10-20 ng/mL) could be classified into either an 11% or an 86% 4-year PSA control cohort using the preoperative prostate biopsy data. These findings were validated using an independent surgical (N = 823) and radiation (N = 473) data set. Percent-positive prostate biopsies added clinically significant information regarding time to PSA failure after RP.
The percentage of positive prostate biopsies should be considered in conjunction with the PSA level, biopsy Gleason score, and clinical T stage when counseling patients with newly diagnosed and clinically localized prostate cancer about PSA outcome after RP or EBRT.
对于前列腺特异性抗原（PSA）检测到或可触及前列腺癌的男性患者，根治性前列腺切除术（RP）或外照射放疗（EBRT）后，前列腺活检阳性率在预测PSA结局方面的临床实用性尚未明确。
采用Cox回归多变量分析，在960名男性患者中确定前列腺活检阳性率是否能提供关于RP后PSA结局的临床相关信息，同时考虑基于治疗前PSA浓度、活检Gleason评分以及1992年美国癌症联合委员会临床T分期所确定的风险组。
在中危组中，80%的患者（T（2b）期或活检Gleason评分为7或PSA为10 - 20 ng/mL）使用术前前列腺活检数据可被分为4年PSA控制率分别为11%或86%的队列。这些发现通过独立的手术（N = 823）和放疗（N = 473）数据集得到验证。前列腺活检阳性率为RP后至PSA失败时间增加了具有临床意义的信息。
在为新诊断的临床局限性前列腺癌患者提供关于RP或EBRT后PSA结局的咨询时，应结合PSA水平、活检Gleason评分和临床T分期考虑前列腺活检阳性率。
