Naya Yoshio, Ayala Alberto G, Tamboli Pheroze, Babaian R Joseph
Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Urology. 2004 Mar;63(3):503-8. doi: 10.1016/j.urology.2003.09.066.
To evaluate whether the presence of, or the number of cores containing, high-grade prostatic intraepithelial neoplasia (PIN) found in men who underwent initial extended multisite biopsy could predict which men would have prostate cancer on subsequent repeat biopsies.
Between June 1997 and January 2003, 1086 men underwent initial prostate biopsy for early detection of prostate cancer using an extended multisite biopsy scheme. Of these, 175 men without cancer underwent at least one repeat biopsy (range one to three; median interval between biopsies, 3 months). Among these 175 patients, 47 had high-grade PIN on initial biopsy.
The initial extended biopsy identified cancer in 33.8% (367 of 1086) and high-grade PIN in 20.8% (226 of 1086). The incidence of high-grade PIN only in patients found to have cancer on initial biopsy was 29.7% (109 of 367). The presence of high-grade PIN was associated with concurrent prostate cancer at the initial biopsy (P <0.0001). Overall, repeat biopsy identified cancer in 18.3% of the 175 men. Of the 47 men with high-grade PIN, 5 (10.6%) were found to have cancer on repeat biopsy. The number of biopsy specimens positive for high-grade PIN on initial biopsy was not associated with the likelihood of prostate cancer on repeat biopsy. Multivariate logistic regression analysis showed that neither the presence of high-grade PIN nor the number of cores containing high-grade PIN on initial biopsy were predictors for prostate cancer on repeat biopsy.
The number of cores positive for high-grade PIN was not predictive for cancer on repeat biopsy.
评估在接受初次扩大多点活检的男性中，发现的高级别前列腺上皮内瘤变（PIN）的存在情况或含有PIN的活检芯数量，能否预测哪些男性在随后的重复活检中会患有前列腺癌。
1997年6月至2003年1月期间，1086名男性接受了初次前列腺活检，采用扩大多点活检方案以早期检测前列腺癌。其中，175名无癌男性接受了至少一次重复活检（范围为1至3次；活检之间的中位间隔为3个月）。在这175名患者中，47名在初次活检时患有高级别PIN。
初次扩大活检发现33.8%（1086例中的367例）患有癌症，20.8%（1086例中的226例）患有高级别PIN。仅在初次活检发现患有癌症的患者中，高级别PIN的发生率为29.7%（367例中的109例）。高级别PIN的存在与初次活检时同时存在前列腺癌相关（P<0.0001）。总体而言，重复活检在175名男性中发现18.3%患有癌症。在47名患有高级别PIN的男性中，5名（10.6%）在重复活检时被发现患有癌症。初次活检时高级别PIN阳性的活检标本数量与重复活检时患前列腺癌的可能性无关。多因素逻辑回归分析显示，初次活检时高级别PIN的存在情况或含有高级别PIN的活检芯数量均不是重复活检时前列腺癌的预测因素。
高级别PIN阳性的活检芯数量不能预测重复活检时的癌症情况。
