Dominguez-Escrig J L, McCracken S R C, Greene D
Urology Department, Sunderland Royal Hospital, Kayll Road, Sunderland SR4 7TP, UK.
Prostate Cancer. 2011;2011:386207. doi: 10.1155/2011/386207. Epub 2010 Dec 9.
Despite decades of use as the "gold standard" in the detection of prostate cancer, the optimal biopsy regimen is still not universally agreed upon. While important aspects such as the need for laterally placed biopsies and the importance of apical cancer are known, repeated studies have shown significant patients with cancer on subsequent biopsy when the original biopsy was negative and an ongoing suspicion of cancer remained. Attempts to maximise the effectiveness of repeat biopsies have given rise to the alternate approaches of saturation biopsy and the transperineal approach. Recent interest in focal treatment of prostate cancer has further highlighted the need for accurate detection of prostate cancer, and in response, the introduction of transperineal template-guided biopsy. While the saturation biopsy approach and the transperineal template approach increase the detection rate of cancer in men with a previous negative biopsy and appear to have acceptable morbidity, there is a lack of clinical trials evaluating the different biopsy strategies. This paper reviews the evolution of prostatic biopsy and current controversies.
尽管前列腺穿刺活检作为前列腺癌检测的“金标准”已使用数十年，但最佳的活检方案仍未得到普遍认可。虽然诸如外侧穿刺活检的必要性以及尖部癌的重要性等重要方面已为人所知，但反复研究表明，当初次活检为阴性但仍怀疑患有癌症时，后续活检仍有相当比例的患者被诊断出患有癌症。为了使重复活检的效果最大化，人们尝试了饱和活检和经会阴活检等替代方法。近期对前列腺癌局部治疗的关注进一步凸显了准确检测前列腺癌的必要性，相应地，经会阴模板引导活检应运而生。虽然饱和活检方法和经会阴模板引导活检方法提高了初次活检阴性男性的癌症检出率，且发病率似乎可以接受，但缺乏评估不同活检策略的临床试验。本文回顾了前列腺穿刺活检的发展历程及当前存在的争议。
