Donahue Timothy, Moul Judd
Department of Surgery, Center for Prostate Disease Research, Uniformed Services University, 1530 East Jefferson Street, Rockville, MD 20852, USA.
Curr Urol Rep. 2002 Jun;3(3):215-21. doi: 10.1007/s11934-002-0067-7.
The introduction of prostate-specific antigen screening has resulted in stage migration and an increased incidence of localized prostate cancer. In this era of increasing nonpalpable disease, it has become necessary to systematically sample the entire prostate gland. Transrectal ultrasound-guided prostate biopsy procedures have evolved greatly over the past decade from the original sextant biopsy. Technological advances, better understanding of zonal anatomy of the prostate, whole mount sectioning of radical prostatectomy specimens, and computer modeling of localized prostate cancers have all led to extended biopsy core protocols directed at the lateral zones of the gland. These have increased the diagnostic accuracy of needle biopsy and have become a standard regimen. However, it remains controversial how to proceed with repeat biopsy in the face of an initial benign diagnosis, and optimal biopsy strategy remains undefined. It is hoped that quantitative analysis of prostate biopsy histology may eventually provide some prognostic information to guide the patient and urologist in preoperative planning.
前列腺特异性抗原筛查的引入导致了分期迁移和局限性前列腺癌发病率的增加。在这个不可触及疾病日益增多的时代，对整个前列腺进行系统采样已变得必要。在过去十年中，经直肠超声引导下的前列腺活检程序已从最初的六分区活检有了很大发展。技术进步、对前列腺分区解剖的更好理解、根治性前列腺切除术标本的全层切片以及局限性前列腺癌的计算机建模，都促使针对腺体外侧区的活检核心方案得到扩展。这些方案提高了针吸活检的诊断准确性，并已成为标准方案。然而，面对初次诊断为良性时如何进行重复活检仍存在争议，最佳活检策略也尚未明确。人们希望对前列腺活检组织学进行定量分析最终可能提供一些预后信息，以指导患者和泌尿外科医生进行术前规划。
