Fink K G, Hutarew G, Pytel A, Schmeller N T
Department of Urology and Andrology, St. Johannsspital, Paracelsus Medical Private University, Salzburg, Austria.
Urol Int. 2005;75(3):209-12. doi: 10.1159/000087795.
The aim of the study was to compare the prostate biopsy outcome by using either standard or extended cutting length of the needles.
A total of 74 consecutive prostates from radical prostatectomy were used. Two sextant biopsies were performed ex vivo. We developed a precise simulation of a transrectal biopsy procedure using ultrasound for guiding the needle. In the first set of biopsies an 18-gauge tru cut needle with 19 mm cutting length, powered by a automatic biopsy gun was used. In the second set a single use gun with an 18-gauge end-cutting needle and 29 mm cutting length was used.
In the set of sextant biopsies using 19 mm cutting length 49 (66%) carcinomas were found. In the set of sextant biopsies using 29 mm cutting length 58 (78%) of the tumors were detected. 24 (32%) prostates showed tumor in the transition zones, but there was no transition-zone-only cancer in this study. Nevertheless taking longer cores led to an improvement in prostate cancer detection of 18%.
In this ex vivo setting the use of 29 mm cutting length for prostate biopsy led to an significant improvement in cancer detection. As we found the end-cutting needle not suitable for use in the patient, these results support the idea to develop a longer tru cut needle and corresponding gun for further clinical investigations.
本研究旨在比较使用标准针长和延长针长的穿刺针进行前列腺活检的结果。
共使用了74例连续的前列腺癌根治术切除的前列腺标本。在体外进行了两次六分区活检。我们开发了一种精确模拟经直肠活检过程的方法，使用超声引导穿刺针。在第一组活检中，使用了由自动活检枪驱动的18号切割长度为19 mm的Tru-Cut穿刺针。在第二组活检中，使用了一次性活检枪，配备18号端切穿刺针，切割长度为29 mm。
在使用19 mm切割长度的六分区活检组中，发现49例（66%）癌灶。在使用29 mm切割长度的六分区活检组中，检测到58例（78%）肿瘤。24例（32%）前列腺在移行区显示有肿瘤，但本研究中没有仅位于移行区的癌症。然而，获取更长的组织条使前列腺癌的检测率提高了18%。
在本体外研究中，使用29 mm切割长度进行前列腺活检可显著提高癌症检测率。由于我们发现端切穿刺针不适用于患者，这些结果支持开发更长的Tru-Cut穿刺针及相应活检枪用于进一步临床研究的想法。
