Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
BJU Int. 2012 Jul;110(2 Pt 2):E46-9. doi: 10.1111/j.1464-410X.2011.10689.x. Epub 2011 Nov 1.
It is known that the end-fire probe detects more prostate cancer on initial prostate biopsy, but there is no literature looking at the influence of type of probe on repeat biopsy. Given that the literature on the influence of ultrasonography probe on repeat prostate biopsy is non-existent, the present study adds information which may help urologists improve their chances of detecting prostate cancer on prostate biopsy. Determining which type of probe to use on a prostate biopsy is a simple external factor that may help improve patient management.
To determine if the type of transrectal ultrasonography (TRUS) probe used during repeat prostate biopsy influences prostate cancer detection rates.
We conducted a retrospective chart review of 680 men undergoing repeat prostate biopsy at our institution between 2000 and 2010. Patient mean (range) age was 64.2 (39-95) years. The median (range) prostate-specific antigen (PSA) level was 5.5 (0.37-33.8) ng/mL and median (range) free PSA was 17 (5-45) %. Patient age, PSA, prostate volume, number of biopsy cores, time interval between initial and repeat biopsy, digital rectal examination and pathological findings were all included in a multivariate logistic regression analysis.
The use of an end-fire probe on repeat biopsy significantly increased prostate cancer detection (odds ratio [OR] 1.59, 95% confidence interval [CI]: 1.03-2.46). The time interval between 1(st) and 2(nd) biopsy was also significant (OR 1.46, 95% CI: 1.11-1.09). On univariate analysis, white race (OR 0.66, 95% CI: 0.44-0.99), increasing prostate volume (OR 0.70, 95% CI: 0.55-0.89), and higher free PSA (OR 0.54, 95% CI: 0.34-0.84) were associated with a decreased risk of cancer. When evaluating the different permutations of using an end-fire or side-fire probe on initial or repeat biopsy, there was no difference in prostate cancer detection regardless of order of use of an end-fire or side-fire probe.
An end-fire probe is associated with improved prostate cancer detection rates on both initial and repeat biopsy. The order of probe use does not appear to matter.
确定在重复前列腺活检中使用的经直肠超声（TRUS）探头的类型是否会影响前列腺癌的检出率。
我们对 2000 年至 2010 年间在我院行重复前列腺活检的 680 例男性患者进行了回顾性图表审查。患者平均（范围）年龄为 64.2（39-95）岁。中位（范围）前列腺特异性抗原（PSA）水平为 5.5（0.37-33.8）ng/ml，中位（范围）游离 PSA 为 17（5-45）%。患者年龄、PSA、前列腺体积、活检芯数、初次和重复活检之间的时间间隔、直肠指检和病理结果均纳入多变量逻辑回归分析。
重复活检中使用端射探头可显著提高前列腺癌检出率（优势比[OR]1.59，95%置信区间[CI]：1.03-2.46）。初次和第二次活检之间的时间间隔也很重要（OR 1.46，95%CI：1.11-1.09）。单因素分析显示，白人种族（OR 0.66，95%CI：0.44-0.99）、前列腺体积增大（OR 0.70，95%CI：0.55-0.89）和较高的游离 PSA（OR 0.54，95%CI：0.34-0.84）与癌症风险降低相关。当评估在初次或重复活检中使用端射或侧射探头的不同排列时，无论端射或侧射探头的使用顺序如何，前列腺癌的检出率均无差异。
端射探头与初次和重复活检中前列腺癌检出率的提高有关。探头使用顺序似乎并不重要。
