Postma R, Schröder F H, van der Kwast T H
Department of Urology, Josephine Nefkens Institute, Erasmus Medical Center, Rotterdam, The Netherlands.
Urology. 2005 Apr;65(4):745-9. doi: 10.1016/j.urology.2004.10.046.
To evaluate whether the incidence of atrophy reported on sextant biopsies is associated with subsequent prostate cancer detection and to obtain a more thorough analysis of the different categories and extent of atrophy, we performed a review of benign biopsy cores.
In the Rotterdam section of the European Randomized Study of Screening for Prostate Cancer, 4117 and 1840 men underwent sextant biopsy in the first and second screening round (4-year interval), respectively. Sextant biopsy was prompted by elevated prostate-specific antigen levels. For review, randomly taken benign sextant biopsies (n = 202) with a follow-up of at least 8 years were chosen.
Before review, atrophy was reported in the biopsies of 11.4% and 8.7% of the first and second round, respectively. The prostate cancer incidence during 8 years of follow-up after an initial diagnosis of atrophy was 10.4%, which was not significantly different than the 12.3% of cancers detected after a benign diagnosis without reference to atrophy. After review, the incidence of simple atrophy, post-atrophic hyperplasia, and sclerotic atrophy in sextant biopsies was 91%, 47%, and 9%, respectively. Extensive atrophy was observed in 5% of biopsies. Only 2 men (4.7%) in the reviewed group had a subsequent diagnosis of prostate cancer in the 8 years of follow-up. Additionally, prostatic intraepithelial neoplasia was diagnosed in 3 men (7.0%) in the second screening round.
Atrophy, especially its simple form, is a very common lesion in prostate biopsy cores (94%). Atrophy in an asymptomatic population undergoing screening was not associated with a greater prostate cancer or prostatic intraepithelial neoplasia incidence during subsequent screening rounds.
为了评估在六分区活检中报告的萎缩发生率是否与随后前列腺癌的检测相关，并对萎缩的不同类别和程度进行更全面的分析，我们对良性活检组织进行了回顾。
在欧洲前列腺癌筛查随机研究的鹿特丹部分，分别有4117名和1840名男性在第一轮和第二轮筛查（间隔4年）中接受了六分区活检。六分区活检是由前列腺特异性抗原水平升高引发的。为进行回顾，选取了随机抽取的202份良性六分区活检组织，其随访时间至少为8年。
在回顾之前，第一轮和第二轮活检中分别有11.4%和8.7%的组织报告有萎缩。在最初诊断为萎缩后的8年随访期间，前列腺癌的发生率为10.4%，与未提及萎缩的良性诊断后检测到的癌症发生率12.3%相比，无显著差异。回顾后，六分区活检中单纯萎缩、萎缩后增生和硬化性萎缩的发生率分别为91%、47%和9%。5%的活检组织观察到广泛萎缩。在回顾组中，只有2名男性（4.7%）在8年随访中有后续前列腺癌诊断。此外，在第二轮筛查中有3名男性（7.0%）被诊断为前列腺上皮内瘤变。
萎缩，尤其是其单纯形式，是前列腺活检组织中非常常见的病变（94%）。在接受筛查的无症状人群中，萎缩与后续筛查轮次中更高的前列腺癌或前列腺上皮内瘤变发生率无关。
