Jones J Stephen, Patel Amit, Schoenfield Lynn, Rabets John C, Zippe Craig D, Magi-Galluzzi Cristina
Glickman Urological Institute, the Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
J Urol. 2006 Feb;175(2):485-8. doi: 10.1016/S0022-5347(05)00211-9.
We reported on the results of a sequential cohort study comparing office based saturation prostate biopsy to traditional 10-core sampling as an initial biopsy.
Based on improved cancer detection of office based saturation prostate biopsy repeat biopsy, we adopted the technique as an initial biopsy strategy to improve cancer detection. Two surgeons performed 24-core saturation prostate biopsies in 139 patients undergoing initial biopsy under periprostatic local anesthesia. Indication for biopsy was an increased PSA of 2.5 ng/dl or greater in all patients. Results were compared to those of 87 patients who had previously undergone 10-core initial biopsies.
Cancer was detected in 62 of 139 patients (44.6%) who underwent saturation biopsy and in 45 of 87 patients (51.7%) who underwent 10-core biopsy (p >0.9). Breakdown by PSA level failed to show benefit to the saturation technique for any degree PSA increase. Men with PSA 2.5 to 9.9 ng/dl were found to have cancer in 53 of 122 (43.4%) saturation biopsies and 26 of 58 (44.8%) 10-core biopsies. Complications included 3 cases of prostatitis in each group. Rectal bleeding was troublesome enough to require evaluation only in 3 men in the saturation group and 1 in the 10-core group.
Although saturation prostate biopsy improves cancer detection in men with suspicion of cancer following a negative biopsy, it does not appear to offer benefit as an initial biopsy technique. These findings suggest that further efforts at extended biopsy strategies beyond 10 to 12 cores are not appropriate as an initial biopsy strategy.
我们报告了一项序贯队列研究的结果，该研究比较了基于门诊的饱和式前列腺活检与传统的10针穿刺活检作为初始活检的情况。
基于门诊饱和式前列腺活检重复活检能提高癌症检出率，我们采用该技术作为初始活检策略以提高癌症检出率。两名外科医生在139例接受前列腺周围局部麻醉的初次活检患者中进行了24针饱和式前列腺活检。所有患者的活检指征均为前列腺特异性抗原（PSA）升高2.5 ng/dl或更高。将结果与87例先前接受过10针初次活检的患者的结果进行比较。
在接受饱和式活检的139例患者中有62例（44.6%）检测到癌症，在接受10针活检的87例患者中有45例（51.7%）检测到癌症（p>0.9）。按PSA水平细分未显示出饱和式技术对任何程度的PSA升高有优势。PSA为2.5至9.9 ng/dl的男性中，122例饱和式活检中有53例（43.4%）检测到癌症，58例10针活检中有26例（44.8%）检测到癌症。并发症包括每组3例前列腺炎。仅在饱和式活检组的3名男性和10针活检组的1名男性中，直肠出血严重到需要评估。
尽管饱和式前列腺活检在初次活检阴性后怀疑患有癌症的男性中可提高癌症检出率，但作为初始活检技术似乎并无优势。这些发现表明，作为初始活检策略，进一步努力采用超过10至12针的扩展活检策略并不合适。
