University of Medicine, Dentistry of New Jersey, Newark, NJ, USA.
Urology. 2011 May;77(5):1148-52. doi: 10.1016/j.urology.2010.11.052. Epub 2011 Feb 18.
To report the incidence of transition zone (TZ) cancer in patients undergoing transperineal template-guided mapping biopsy (TTMB) of the prostate gland.
Five hundred thirty-nine consecutive patients underwent TTMB by means of an anatomic technique with sampling of 24 defined prostate regions. The position of each biopsy core was recorded in 3 dimensions. For every patient, the location of each positive biopsy core, the number of positive cores, the Gleason score, the percentage involvement of each core, and the presence/absence of perineural invasion was documented.
The median volumetric prostate volume was 56.0 cm(3) with an ellipsoid TZ volume of 20.1 cm(3). The median number of TTMB cores was 58 with a median of 11 TZ cores. Two hundred eighty-seven (53.2%) were diagnosed with prostate cancer. TZ cancer was detected in 130 (45.3%) of patients with prostate cancer but only 6 (4.6%) were confined to the TZ. Overall, 38.9% of TZ cores were positive for malignancy. Of the TZ cancers, 37 (28.5%), 64 (49.2%), and 29 (22.3%) were assigned Gleason scores 6, 7, and 8-10. Compared with a standard 12-core biopsy approach, the results of the TZ biopsy upgraded the Gleason score in 24.6% of patients. Only 4 cancers (3.1%) involving the TZ were classified as clinically insignificant.
Although only 4.6% of cancers were confined to the TZ, 45.3% of all prostate cancer patients had TZ involvement.
报告经会阴模板引导前列腺靶向穿刺活检（TTMB）患者中转区（TZ）癌的发病率。
539 例连续患者采用解剖学技术进行 TTMB，对 24 个定义明确的前列腺区域进行采样。记录每个活检芯的位置在 3 个维度上。对于每位患者，记录每个阳性活检芯的位置、阳性芯的数量、Gleason 评分、每个芯的受累百分比以及有无神经周围侵犯的情况。
平均前列腺体积为 56.0cm3，椭圆形 TZ 体积为 20.1cm3。平均 TTMB 芯数量为 58 个，平均 TZ 芯数量为 11 个。287 例（53.2%）诊断为前列腺癌。130 例（45.3%）前列腺癌患者发现 TZ 癌，但仅 6 例（4.6%）局限于 TZ。总体而言，38.9%的 TZ 芯为恶性肿瘤。在 TZ 癌中，37（28.5%）、64（49.2%）和 29（22.3%）被分配为 Gleason 评分 6、7 和 8-10。与标准的 12 芯活检方法相比，TZ 活检结果使 24.6%的患者 Gleason 评分升高。只有 4 例（3.1%）累及 TZ 的癌症被归类为临床意义不大。
尽管只有 4.6%的癌症局限于 TZ，但所有前列腺癌患者中有 45.3%存在 TZ 受累。
