常规超声引导下系统性12针前列腺穿刺活检在前列腺肿瘤定位中的低准确性。

Low accuracy of routine ultrasound-guided systematic 12-core biopsies in prostate tumor mapping.

作者信息

Belas Olivier, Hupertan Vincent, Comperat Eva, Renard-Penna Raphaële, Mozer Pierre, Bitker Marc-Olivier, Rouprêt Morgan

机构信息

Department of Urology, Pitié-Salpétrière Hospital, GHU Est, Assistance-Publique Hôpitaux de Paris, Paris, France.

出版信息

Can J Urol. 2012 Aug;19(4):6366-72.

PMID:22892260

Abstract

INTRODUCTION

To determine the accuracy of a 12-core biopsy protocol in assessing the location of prostate tumors within radical prostatectomy (RP) specimens.

MATERIALS AND METHODS

A consecutive series of patients with T1c stage prostate cancer who had undergone 12 ultrasound-guided prostate biopsies prior to RP was considered. The locations of the biopsies from prostate gland mapping were compared with the locations of tumor tissues obtained after analysis of the prostate specimens.

RESULTS

Overall, 78 patients (27.4%) were included. The median PSA level was 6 ng/mL. The median prostate weight was 45 g (range 22 to 102). Overall, 936 biopsies were performed in the 78 men, of which 254 biopsies were positive. The mean number of positive biopsies per patient was 3.7 (range 1 to 12). Pathologic examination of the surgical specimens revealed that 58 (74.4%) patients had pT2 disease and 20 patients (25.6%) had locally advanced disease (pT3). The biopsy protocol's sensitivity, specificity and positive predictive value for tumor location were 0.34, 0.83 and 0.84. The performance of the protocol was modest in assessing the exact tumor location (area under curve (AUC) 0.581, 95% confidence interval (CI) 0.489-0.719).

CONCLUSIONS

Routine, ultrasound-guided, systematic 12-core biopsies lack precision in prostate tumor mapping.

摘要

引言

确定12针活检方案在评估前列腺癌根治术（RP）标本中前列腺肿瘤位置的准确性。

材料与方法

纳入一系列连续的T1c期前列腺癌患者，这些患者在RP术前接受了12次超声引导下的前列腺活检。将前列腺腺体定位活检的位置与前列腺标本分析后获得的肿瘤组织位置进行比较。

结果

总共纳入78例患者（27.4%）。前列腺特异性抗原（PSA）中位数水平为6 ng/mL。前列腺重量中位数为45 g（范围22至102 g）。78名男性患者共进行了936次活检，其中254次活检呈阳性。每位患者阳性活检的平均次数为3.7次（范围1至12次）。手术标本的病理检查显示，58例（74.4%）患者患有pT2期疾病，20例（25.6%）患者患有局部进展期疾病（pT3）。活检方案对肿瘤定位的敏感性、特异性和阳性预测值分别为0.34、0.83和0.84。该方案在评估确切肿瘤位置方面表现一般（曲线下面积（AUC）为0.581，95%置信区间（CI）为0.489 - 0.719）。