Park Paul C, Mai Kien T, Roustan Delatour Nicolas L D, Morash Christopher, Cagiannos Ilias
Division of Anatomical Pathology, Department of Pathology and Laboratory Medicine, The Ottawa Hospital, Civic Campus and University of Ottawa, Ottawa, Ontario, Canada.
BJU Int. 2006 Nov;98(5):986-8. doi: 10.1111/j.1464-410X.2006.06453.x.
To investigate the predictive value (PV) for all prostate cancers and for clinically significant cancer undiagnosed after a 10-core biopsy protocol, as the 10-core transrectal ultrasonography-guided biopsy is considered the standard technique of prostatic biopsy due to its high rate of detection of prostatic adenocarcinoma.
In all, 132 consecutive radical prostatectomy (RP) specimens, with their corresponding 10-core biopsies, were reviewed. Cases with unilateral core involvement by prostate cancer were retained for study. Morphometric analysis was conducted on the biopsy-negative hemi-prostates to determine the PV of the biopsy protocol with respect to the size, position and clinical significance of the lesion.
In all, 70 resected prostates (RP) had unilateral core involvement by prostate cancer. In 38 cases, there was cancer in the biopsy-negative hemi-prostates (group 1); in the remaining 32 the hemi-prostates were free of cancer (group 2). Group 1 was categorized by morphometric criteria. Specifically, 23 cases had one to eight foci of prostate cancer in the posterior nontransitional zone (NTZ) (group 1a), while 15 had two to six foci of prostate cancer in the transitional zone (TZ), or the anterior horn (AH) of the peripheral zone or the TZ and AH (group 1b). There were two cases with clinically significant prostate cancer in group 1a, and six in group 1b.
The PV of a negative five-core biopsy protocol on a hemi-prostate is 54% for prostate cancer and 11% for clinically significant prostate cancer. Most clinically significant prostate cancers were in the AH/TZ of the prostate.
由于经直肠超声引导下的10针穿刺活检因其对前列腺腺癌的高检出率而被视为前列腺活检的标准技术，本研究旨在探讨其对所有前列腺癌以及10针穿刺活检后未诊断出的临床显著性癌的预测价值（PV）。
回顾性分析132例连续接受根治性前列腺切除术（RP）的标本及其相应的10针穿刺活检结果。保留单侧穿刺针芯有前列腺癌累及的病例进行研究。对穿刺活检阴性的半侧前列腺进行形态学分析，以确定穿刺活检方案对病变大小、位置及临床意义的预测价值。
共有70例接受RP的前列腺单侧穿刺针芯有前列腺癌累及。38例中，穿刺活检阴性的半侧前列腺存在癌（第1组）；其余32例半侧前列腺无癌（第2组）。第1组按形态学标准分类。具体而言，23例在后外侧非移行区（NTZ）有1至8个前列腺癌病灶（第1a组），而15例在移行区（TZ）、外周区前角（AH）或TZ和AH有2至6个前列腺癌病灶（第1b组）。第1a组有2例临床显著性前列腺癌，第1b组有6例。
半侧前列腺5针穿刺活检阴性对前列腺癌的预测价值为54%，对临床显著性前列腺癌的预测价值为11%。大多数临床显著性前列腺癌位于前列腺的AH/TZ。
