The Prostate Centre, 32 Wimpole Street, London W1G 8GT, UK.
BJU Int. 2012 Jun;109(12):1750-4. doi: 10.1111/j.1464-410X.2011.10809.x. Epub 2011 Dec 22.
What's known on the subject? and What does the study add? Due to the fear of missing clinically significant cancer, it is often uncertain whether a repeat biopsy should be performed in men with ≥ 1 prior negative prostate biopsies but persistent suspicion of prostate cancer. However, the repeat biopsy may again be negative and a biopsy may be associated with anxiety, discomfort and complications (resulting in hospitalisation in 4.1% of men). This review discusses strategies to optimise repeat biopsy procedures in order to better predict the biopsy outcome. Optimising repeat biopsy procedures include adjusting the location and number of cores and the use of MRI to detect suspicious areas. The use of diagnostic markers, e.g. (Prostate CAncer) gene 3, which is predictive of biopsy outcome, can aid in guiding repeat biopsy decisions and reduce the number of unnecessary and uncomfortable biopsies. To review strategies to optimise repeat biopsy procedures and to better predict the biopsy outcome. As it is often uncertain whether a repeat biopsy should be performed in men with ≥ 1 previous negative prostate biopsies but persistent suspicion of prostate cancer. The repeat biopsy may also be negative and a biopsy may be associated with anxiety, discomfort and occasionally (severe) complications. A search in PubMed was performed to find English language original and review articles related to repeat prostate biopsies. Strategies to optimise repeat biopsy procedures include applying the appropriate indications and adjusting the location and number of biopsy cores. The PROGENSA™ Prostate CAncer gene 3 (PCA3) Assay is a highly prostate cancer-specific test. A higher PCA3 Score corresponds with an increased probability of a positive repeat biopsy and including the PCA3 Score in multivariate models significantly increased their predictive accuracy for predicting repeat biopsy outcome. The PCA3 Score seems also to be predictive of future biopsy outcome. In clinical practice it is often uncertain whether a prostate biopsy should be repeated or not. Optimising repeat biopsy procedures and the use of diagnostic markers, such as PCA3, can increase the probability of a positive repeat biopsy and reduce the number of unnecessary and uncomfortable biopsies.
已知内容是什么？研究有何补充？由于担心遗漏有临床意义的癌症，对于那些有≥1 次前列腺活检阴性病史但仍持续怀疑前列腺癌的男性，是否需要再次进行活检往往存在不确定性。然而，再次活检可能仍为阴性，且活检可能会导致焦虑、不适和并发症（导致 4.1%的男性住院）。本综述讨论了优化重复活检程序的策略，以更好地预测活检结果。优化重复活检程序包括调整活检部位和活检芯数量，以及使用 MRI 检测可疑区域。使用诊断标志物（如前列腺癌基因 3，可预测活检结果）有助于指导重复活检决策，并减少不必要和不舒服的活检次数。综述优化重复活检程序以更好地预测活检结果的策略。由于对于那些有≥1 次前列腺活检阴性病史但仍持续怀疑前列腺癌的男性，是否需要再次进行活检往往存在不确定性。再次活检也可能为阴性，且活检可能会导致焦虑、不适，偶尔（严重）并发症。在 PubMed 上进行了英文原始和综述文章的检索，这些文章与重复前列腺活检相关。优化重复活检程序的策略包括应用适当的适应证，并调整活检部位和活检芯数量。PROGENSA 前列腺癌基因 3（PCA3）检测是一种高度特异性的前列腺癌检测方法。较高的 PCA3 评分对应着阳性重复活检的可能性增加，将 PCA3 评分纳入多变量模型显著提高了其预测重复活检结果的准确性。PCA3 评分似乎也可预测未来的活检结果。在临床实践中，通常不确定是否应再次进行前列腺活检。优化重复活检程序和使用诊断标志物（如 PCA3）可以提高阳性重复活检的概率，并减少不必要和不舒服的活检次数。
