Department of Urology, Bedford Hospital, Bedford, UK.
Int Urol Nephrol. 2013 Dec;45(6):1539-44. doi: 10.1007/s11255-013-0506-z. Epub 2013 Jul 30.
Increasing life expectancy and PSA testing has increased the number of men over the age of seventy-five presenting for investigation of potential prostate malignancies. Prostatic biopsies provide diagnostic information; however, they are invasive and may not alter management decisions. Therefore, this study aimed to investigate whether prostate biopsies in this age group were justified.
All men aged 75 years and older who underwent prostatic biopsies between January 2010 and November 2011 at Bedford Hospital were identified and the indication for the biopsies, histopathological results and subsequent management plan investigated.
One hundred and thirty-eight (138) prostatic biopsies were undertaken and malignancies identified in 60/138 (43 %) cases. Prebiopsy PSA and examination findings had a poor positive predictive value of 54 %. Fifty-five out of sixty (92 %) cancers were classified as high or medium risk disease with 30/60 (50 %) patients commencing radiotherapy treatment with curative intent.
In selected patients aged 75 years or over, prostatic biopsies provide important diagnostic information which directly impacts on clinical decisions, supporting their use in this age group.
预期寿命的延长和 PSA 检测的增加导致七十五岁以上男性人群中潜在前列腺恶性肿瘤的就诊数量增加。前列腺活检提供诊断信息，但具有侵袭性，且可能不会改变管理决策。因此，本研究旨在探讨在该年龄段进行前列腺活检是否合理。
本研究回顾性分析了 2010 年 1 月至 2011 年 11 月在贝德福德医院接受前列腺活检的所有 75 岁及以上男性患者，分析了活检的适应证、组织病理学结果和后续管理方案。
共进行了 138 例前列腺活检，60/138（43%）例发现恶性肿瘤。活检前 PSA 和检查结果的阳性预测值较低，为 54%。60 例癌症中有 55 例（92%）为高或中危疾病，其中 30 例（50%）患者开始接受有治愈意图的放疗治疗。
在特定的 75 岁及以上患者中，前列腺活检可提供重要的诊断信息，直接影响临床决策，支持在该年龄段使用。
