Hong Y Mark, Lai Frank C, Chon Chris H, McNeal John E, Presti Joseph C
Department of Urology, Stanford University School of Medicine, Stanford, CA 94305, USA.
Urol Oncol. 2004 Jan-Feb;22(1):7-10. doi: 10.1016/S1078-1439(03)00147-9.
The object of our study was to characterize the biopsy features of cancers detected in a repeat biopsy population stratified on the basis of the type of prior negative biopsy. We studied 218 patients with a prior negative biopsy who underwent a 10-core extended systematic biopsy scheme, and a subset (n = 139) underwent additional 6 anteriorly directed biopsies. Clinicopathologic features of patients with cancer on the biopsy were compared as a function of type of prior negative biopsy. Overall and unique cancer detection rates were calculated for each of the biopsy sites. Cancer detection rates tended to be higher in patients who had undergone a prior sextant biopsy compared to a prior extended biopsy scheme (39% vs. 28%). Trends towards more positive cores and greater total core length of cancer involvement were seen in patients who had undergone a prior negative sextant biopsy. Apical and laterally directed biopsies had higher overall and unique cancer detection rates in patients who had undergone a prior negative sextant biopsy. Anteriorly directed biopsies had a low unique cancer detection rate in all patients. We conclude that in patients undergoing repeat biopsy, the detection rate is affected by the extent of the prior biopsy. Clinicopathologic features of cancers detected on repeat biopsy tend to be worse in patients who have undergone a prior negative sextant biopsy compared to a negative prior extended biopsy.
我们研究的目的是描述在根据先前阴性活检类型分层的重复活检人群中检测到的癌症的活检特征。我们研究了218例先前活检为阴性且接受了10针扩展系统活检方案的患者，其中一部分患者（n = 139）还接受了额外的6针前向活检。根据先前阴性活检的类型，对活检发现癌症的患者的临床病理特征进行了比较。计算每个活检部位的总体癌症检出率和独特癌症检出率。与先前接受扩展活检方案的患者相比，先前接受六分区活检的患者的癌症检出率往往更高（39% 对 28%）。在先前六分区活检为阴性的患者中，可见癌灶阳性针数更多、癌灶累及的总针长更长的趋势。在先前六分区活检为阴性的患者中，顶端和侧向活检的总体癌症检出率和独特癌症检出率更高。在前向活检中，所有患者的独特癌症检出率都很低。我们得出结论，在接受重复活检的患者中，检出率受先前活检范围的影响。与先前扩展活检为阴性的患者相比，先前六分区活检为阴性的患者在重复活检时检测到的癌症的临床病理特征往往更差。
