Qayyum Tahir, Willder Jennifer M, Horgan Paul G, Edwards Joanne, Underwood Mark A
Unit of Experimental Therapeutics, Institute of Cancer, College of MVLS, University of Glasgow, Western Infirmary, Glasgow, UK.
School of Medicine, College of MVLS, University of Glasgow, Royal Infirmary, Glasgow, UK.
Curr Urol. 2013 Aug;7(1):24-7. doi: 10.1159/000343548. Epub 2013 Jul 28.
To evaluate whether the number of biopsies performed via transrectal ultrasound (TRUS) accurately predicts pathological parameters such as Gleason sum, prostatic intraepithelial neoplasia and perineural invasion of the final prostatectomy specimen.
The cohort consisted of 99 patients whom had undergone radical prostatectomy. Comparisons were made between the number of biopsies utilised and the presence of the pathological parameters from tissue at time of diagnosis and tissue from the final prostatectomy.
A significant difference was noted between Gleason sum, prostatic intraepithelial neoplasia and perineural invasion from tissue at time of diagnosis irrespective of the number of biopsies utilised and tissue from the radical specimen (p < 0.001, p < 0.001, p < 0.001 respectively). No difference was noted in the mean Gleason sum when 11-14 biopsies were utilised at TRUS and the Gleason sum from the radical specimen.
We have demonstrated that the number of biopsies utilised at time of TRUS for diagnosis predicts the accuracy of pathological parameters in the final radical prostatectomy specimen. We believe that 11-14 biopsies should be utilised at time of TRUS as this allows a higher accuracy in the Gleason sum and therefore allows optimum treatment plans to be devised.
评估经直肠超声（TRUS）引导下活检的数量是否能准确预测最终前列腺切除标本的病理参数，如Gleason评分、前列腺上皮内瘤变和神经周围侵犯情况。
该队列由99例行根治性前列腺切除术的患者组成。对活检所用数量与诊断时组织及最终前列腺切除组织的病理参数情况进行比较。
无论活检数量多少，诊断时组织的Gleason评分、前列腺上皮内瘤变和神经周围侵犯情况与根治标本组织之间均存在显著差异（分别为p < 0.001、p < 0.001、p < 0.001）。当TRUS引导下进行11 - 14次活检时，其平均Gleason评分与根治标本的Gleason评分无差异。
我们已经证明，TRUS诊断时所用活检数量可预测最终根治性前列腺切除标本中病理参数的准确性。我们认为，TRUS检查时应进行11 - 14次活检，因为这样能提高Gleason评分的准确性，从而制定出最佳治疗方案。
