Punnen Sanoj, Nam Robert K
Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada M4N 3M5.
Surg Oncol. 2009 Sep;18(3):192-9. doi: 10.1016/j.suronc.2009.02.006. Epub 2009 Mar 12.
The use of PSA for prostate cancer screening has led to a large increase in the number of men undergoing transrectal ultrasonography (TRUS) - guided biopsy of the prostate to determine the presence of prostate cancer. Recently, the indications for prostate biopsy based on PSA level have been questioned and new prostate cancer risk calculators that consider other factors related to prostate cancer have been proposed. Also, there have been significant changes over the years regarding the protocols used to sample the prostate. Most protocols recommend more extensive sampling of the prostate with more laterally directed biopsies of the peripheral zone for both initial and subsequent biopsies. There is still much controversy over the appropriate number and location of biopsy cores, and timing to optimize the diagnosis of prostate cancer on initial and repeat biopsy. Finally, discovery of a new molecular marker independent of the PSA level will be very important in the diagnosis and prognosis of prostate cancer.
前列腺特异性抗原（PSA）用于前列腺癌筛查，使得接受经直肠超声检查（TRUS）引导下前列腺穿刺活检以确定是否存在前列腺癌的男性人数大幅增加。最近，基于PSA水平进行前列腺穿刺活检的指征受到质疑，并且已经提出了考虑与前列腺癌相关的其他因素的新的前列腺癌风险计算器。此外，多年来用于前列腺取样的方案也发生了重大变化。大多数方案建议对前列腺进行更广泛的取样，在初次和后续活检时对外周区进行更多侧向穿刺活检。对于活检针芯的合适数量和位置，以及在初次和重复活检时优化前列腺癌诊断的时机，仍然存在很多争议。最后，发现一种独立于PSA水平的新分子标志物对于前列腺癌的诊断和预后将非常重要。
