Tacoma/Valley Radiation Oncology Centers, Tacoma, WA 98405, USA.
Urol Oncol. 2011 Jul-Aug;29(4):398-404. doi: 10.1016/j.urolonc.2009.08.023. Epub 2009 Nov 27.
Obesity has correlated with adverse pathologic features on prostate biopsy and may predispose to a higher rate of prostate cancer-related death after radical prostatectomy. In this study, we examine the potential relationship between body mass index (BMI) and histopathologic findings on transperineal template-guided mapping biopsy of the prostate (TTMB).
From January 2005 to January 2008, 244 consecutive patients underwent TTMB using an anatomic-based technique. The criteria for TTMB included previously negative transrectal ultrasound (TRUS) biopsy with persistently elevated PSA and/or diagnosis of ASAP, or HG-PIN. The study population was divided into 4 different BMI cohorts (BMI < 25, BMI 25-29.9, BMI 30-34.9, and BMI ≥ 35 kg/m(2)). Biopsy findings were compared between the various BMI cohorts using one-way analysis of variance (ANOVA) and the χ(2) test.
Pre-TTMB clinical parameters, including PSA and prostate volume, were not significantly different between the various BMI cohorts. On average, the study population had undergone 1.7 TRUS biopsies before TTMB. Of the 244 study patients, 112 (45.9%), were diagnosed with prostate adenocarcinoma on TTMB. There was no difference in the rate of cancer detection between the different BMI cohorts. Among patients diagnosed with prostate cancer, BMI did not correlate with Gleason score or percent of positive biopsy cores. When the geography of biopsy-positive cores was analyzed, there were no statistically significant differences in cancer location among the different BMI groups.
In this study, obesity did not predispose toward higher Gleason score, larger cancer volume, or geographic cancer distribution on repeat biopsy with TTMB.
肥胖与前列腺活检中的不良病理特征相关,并且可能会增加前列腺癌根治术后因癌症相关死亡的风险。在这项研究中,我们研究了体重指数(BMI)与经会阴模板引导前列腺穿刺活检(TTMB)的组织病理学检查结果之间的潜在关系。
2005 年 1 月至 2008 年 1 月,244 例连续患者采用基于解剖的技术进行 TTMB。TTMB 的标准包括先前经直肠超声(TRUS)活检结果为阴性但 PSA 持续升高和/或诊断为 ASAP 或 HG-PIN。将研究人群分为 4 个不同的 BMI 队列(BMI < 25、BMI 25-29.9、BMI 30-34.9 和 BMI ≥ 35 kg/m(2))。使用单向方差分析(ANOVA)和 χ(2)检验比较了不同 BMI 队列之间的活检结果。
TTMB 前的临床参数,包括 PSA 和前列腺体积,在不同的 BMI 队列之间没有显著差异。平均而言,研究人群在 TTMB 前进行了 1.7 次 TRUS 活检。在 244 例研究患者中,112 例(45.9%)在 TTMB 中诊断为前列腺腺癌。不同 BMI 队列之间的癌症检出率没有差异。在诊断为前列腺癌的患者中,BMI 与 Gleason 评分或阳性活检核心的百分比无关。当分析阳性活检核心的位置时,不同 BMI 组之间的癌症位置没有统计学上的显著差异。
在这项研究中,肥胖并没有增加重复 TTMB 活检时的 Gleason 评分、更大的癌症体积或癌症的地理分布。