Haarer Chadwick F, Gopalan Anuradha, Tickoo Satish K, Scardino Peter T, Eastham James A, Reuter Victor E, Fine Samson W
Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
J Urol. 2009 Oct;182(4):1337-41. doi: 10.1016/j.juro.2009.06.042. Epub 2009 Aug 14.
We compared prostate cancer detected in transition zone directed needle biopsies with those in corresponding radical prostatectomy specimens.
We reviewed needle biopsy and radical prostatectomy slides from 61 patients in whom cancer was present on transition zone directed needle biopsy. We assessed needle biopsy cancer features as well as transition zone lesions and dominant tumor sites on radical prostatectomy.
Prostate cancer was detected in 25 of 61 left (41%), 23 of 61 right (38%) and 13 of 61 bilateral (21%) transition zone directed needle biopsies. On radical prostatectomy 24 of 61 cases (39.5%) had no tumor in the transition zone, 24 of 61 (39.5%) had nondominant transition zone cancer and 13 of 61 (21%) had a dominant transition zone lesion. Of cases with cancer in the left and right transition zone directed needle biopsy 18 of 38 (47%) and 17 of 36 (47%), respectively, had no transition zone tumor or showed tumor in the contralateral transition zone only at radical prostatectomy. In 8 cases the transition zone directed core was the only one with cancer on needle biopsy and 2 of 8 (25%) such cases showed dominant transition zone cancer at radical prostatectomy.
Cancer identified in transition zone directed needle biopsy cores was not from the transition zone or did not reflect a dominant transition zone lesion in almost 80% of cases. Cancer identified in a left or right transition zone directed needle biopsy did not predict ipsilateral transition zone cancer in almost 50% of cases. These findings suggest that such biopsies do not adequately characterize transition zone tumors. Thus, care should be taken in their interpretation.
我们比较了在经尿道前列腺穿刺活检中检测到的前列腺癌与相应根治性前列腺切除标本中的前列腺癌。
我们回顾了61例经尿道前列腺穿刺活检发现癌症患者的穿刺活检和根治性前列腺切除切片。我们评估了穿刺活检的癌症特征以及根治性前列腺切除术中的移行区病变和主要肿瘤部位。
61例左侧经尿道前列腺穿刺活检中有25例（41%）检测到前列腺癌，61例右侧中有23例（38%），61例双侧中有13例（21%）。在根治性前列腺切除术中，61例中有24例（39.5%）移行区无肿瘤，61例中有24例（39.5%）移行区有非主要癌症，61例中有13例（21%）有主要移行区病变。在左侧和右侧经尿道前列腺穿刺活检发现癌症的病例中，分别有38例中的18例（47%）和36例中的17例（47%）在根治性前列腺切除术中移行区无肿瘤或仅对侧移行区有肿瘤。在8例病例中，经尿道前列腺穿刺活检中仅移行区穿刺针芯发现癌症，其中8例中的2例（25%）在根治性前列腺切除术中显示主要移行区癌症。
在经尿道前列腺穿刺活检针芯中发现的癌症在近80%的病例中并非来自移行区或未反映主要移行区病变。在左侧或右侧经尿道前列腺穿刺活检中发现的癌症在近50%的病例中不能预测同侧移行区癌症。这些发现表明，此类活检不能充分表征移行区肿瘤。因此，在解读时应谨慎。
