Ochiai Atsushi, Troncoso Patricia, Babaian Richard J
Department of Urology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
BJU Int. 2008 Apr;101(7):837-40. doi: 10.1111/j.1464-410X.2007.07355.x. Epub 2007 Dec 5.
To evaluate the effect of the tumour-positive biopsy site at extended biopsy on tumour volume and potential biological significance of prostate cancer.
We retrospectively evaluated radical prostatectomy specimens from 247 consecutive men diagnosed with prostate cancer by extended biopsy. Men who had both a positive sextant and alternative site were excluded, resulting in 132 evaluable men. We assessed age, pretreatment prostate-specific antigen (PSA) level, prostate volume, pathological stage, Gleason score, total tumour volume, and location (sextant or alternative site) of the positive biopsy. Patients were grouped by location of the positive biopsy, i.e. sextant site only or alternative site only, including anterior horn, midline region and transition zone.
A biopsy from a sextant-only or an alternative site only was positive in 42% (56/132) and 58% (76/132) of men, respectively. There was no significant difference in PSA level, number of positive cores, pathological stage, Gleason score, total tumour volume or the incidence of low-volume/low-grade cancer (volume <0.5 mL and a Gleason score of </=6) between the groups. In men with one positive core, there was no significant difference in total tumour volume (median 0.20 vs 0.36 mL, respectively) or in the incidence of low-volume/low-grade cancer (42% vs 40%, respectively) between the groups.
Total tumour volume and the incidence of low-volume/low-grade cancer detected at an alternative site only were comparable to those of cancers detected at a sextant site only. Alternative site biopsy did not increase the incidence of low-volume/low-grade cancers detected.
评估在扩大活检时肿瘤阳性活检部位对前列腺癌肿瘤体积及潜在生物学意义的影响。
我们回顾性评估了247例经扩大活检确诊为前列腺癌的连续男性患者的前列腺根治性切除术标本。排除了六分区活检和其他部位活检均为阳性的男性患者，最终纳入132例可评估患者。我们评估了患者的年龄、术前前列腺特异性抗原（PSA）水平、前列腺体积、病理分期、Gleason评分、肿瘤总体积以及阳性活检部位（六分区或其他部位）。根据阳性活检部位将患者分组，即仅六分区部位或仅其他部位，其他部位包括前角、中线区域和移行带。
仅六分区活检或仅其他部位活检阳性的男性患者分别占42%（56/132）和58%（76/132）。两组之间在PSA水平、阳性活检芯数、病理分期、Gleason评分、肿瘤总体积或小体积/低级别癌（体积<0.5 mL且Gleason评分≤6）的发生率方面无显著差异。在有一个阳性活检芯的男性患者中，两组之间在肿瘤总体积（中位数分别为0.20 vs 0.36 mL）或小体积/低级别癌的发生率（分别为42% vs 40%）方面无显著差异。
仅在其他部位检测到的肿瘤总体积和小体积/低级别癌的发生率与仅在六分区部位检测到的癌症相当。其他部位活检并未增加检测到的小体积/低级别癌的发生率。
