Department of Urology, Royal Hallamshire Hospital, Sheffield, South Yorkshire, United Kingdom.
Urol Oncol. 2013 Jul;31(5):542-8. doi: 10.1016/j.urolonc.2011.02.008. Epub 2011 Apr 13.
To evaluate the prostate cancer (CaP) detection rate and morbidity of performing a transurethral resection biopsy of the prostate (TURBP) at the same time as a saturation biopsy (SBx).
A total of 102 men with previous negative transrectal ultrasound (TRUS) biopsies underwent a SBx under formal anaesthesia. Fifty-four [54 (52.9%)] had a combined SBx and TURBP (Group 1) and 48 (47.1%) had a SBx only (Group 2).
The CaP detection rate in Group 1 was 38.9% (21/54), which was significantly higher than the detection rate of 27.1% (13/48) in Group 2 (P = 0.005). CaP was detected via TURBP in 12 patients (22.2%) from Group 1, including 8 (14.8%) patients who had CaP solely in their TURBP chips. According to the D'Amico classification, 66.6% (14/21) of the cancers in Group 1 were intermediate (n = 4) or high risk (n = 10). Of the 8 'TURBP only' cancers, 75% (6/8) were intermediate (n = 2) or high risk (n = 4). Seven of these eight patients went on to have a radical prostatectomy (RP) but only 2 (28.6%) were found to have a pure anterior/transition zone (TZ) tumor. The postoperative urinary retention and emergency admission rates for Groups 1 and 2 were 29.6% (16/54) vs. 16.6% (8/48) (P = 0.095) and 11.1% (6/54) vs. 5.5% (2/48) (n = 0.17). There was no difference in terms of hematuria (P = 0.54), urinary tract infection (UTI) (P = 0.22), or sepsis (P = 0.21), and patients in Group 1 spent an average of 0.5 days longer in hospital (1.9 vs. 1.4; P = 0.008).
TURBP in association with SBx increases the detection of clinically important CaP. However, this does have to be balanced against the small increased incidence of urinary retention, emergency re-admission, and longer hospital stay.
评估在经直肠超声（TRUS）引导下前列腺系统穿刺活检（SBx）的同时行经尿道前列腺切除术（TURBP）对前列腺癌（CaP）的检出率和发病率的影响。
共 102 名先前 TRUS 活检阴性的男性患者在全麻下接受 SBx。54 名患者（54 名，占 52.9%）同时进行 SBx 和 TURBP（1 组），48 名患者（48 名，占 47.1%）仅进行 SBx（2 组）。
1 组 CaP 的检出率为 38.9%（21/54），明显高于 2 组 27.1%（13/48）的检出率（P=0.005）。1 组中，通过 TURBP 检出 CaP 的患者有 12 名（22.2%），其中 8 名（14.8%）患者的 TURBP 芯片中仅存在 CaP。根据 D'Amico 分类，1 组中 66.6%（21 名患者中的 14 名）的癌症为中危（n=4）或高危（n=10）。在 8 名“仅 TURBP 检出”的癌症患者中，75%（8 名中的 6 名）为中危（n=2）或高危（n=4）。这 8 名患者中有 7 名接受了根治性前列腺切除术（RP），但只有 2 名（28.6%）患者被发现仅存在前/移行区（TZ）肿瘤。1 组和 2 组的术后尿潴留和急诊入院率分别为 29.6%（54 名患者中的 16 名）和 16.6%（48 名患者中的 8 名）（P=0.095）和 11.1%（54 名患者中的 6 名）和 5.5%（48 名患者中的 2 名）（n=0.17）。两组之间血尿（P=0.54）、尿路感染（UTI）（P=0.22）或败血症（P=0.21）的发生率无差异，且 1 组患者的住院时间平均延长 0.5 天（1.9 天比 1.4 天；P=0.008）。
在 SBx 时联合 TURBP 可提高临床上重要的 CaP 的检出率。然而，这必须与尿潴留、急诊再入院和住院时间延长的发生率增加相平衡。
