Hamann M F, Hamann C, Olzem D, Trettel A, Juenemann K P, Naumann C M
Klinik für Urologie und Kinderurologie, Abteilung für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold Heller Straße 7, 24105, Kiel, Deutschland.
Urologe A. 2015 Nov;54(11):1596, 1598-601. doi: 10.1007/s00120-014-3731-x.
Modern imaging modalities improve prostate diagnostics.
This study was performed to determine the outcome characteristics of biopsy procedures using the results of HistoScanning(TM) analysis (HS) for identifying prostate cancer (PCa) in patients with perineal template-guided prostate biopsy.
A total of 104 consecutive men (mean age 69 years, mean PSA 9.9 ng/ml) underwent HS prior to the extended prostate biopsy procedure. Patients received a targeted transperineal (template-assisted) as well as a targeted transrectal prostate biopsy using HS projection reports supplemented by a standardized 14-core systematic transrectal prostate biopsy (Bx). The cancer detection rate was analyzed on the sector level and HS targeted results were correlated to biopsy outcome, sensitivity, specificity, predictive accuracy, negative predictive value (NPV) and positive predictive value (PPV).
Of 104 patients, 44 patients (42%) were found to have PCa. Histology detected atypical small acinar proliferation in 3 patients (2.9%), high-grade prostatic intraepithelial neoplasia in 16 (15.4%), and chronic active inflammation in 74 (71.1%), respectively. The detection rate for each region was significantly higher in HS-targeted biopsies compared to Bx. The detection rate per patient was not significantly different, although a smaller number of regions were biopsied with the targeted approach. The overall sensitivity, specificity, predictive accuracy, NPV, and PPV on the sector level were 37.2, 85.6, 78.6, 88.7 and 30.8%, respectively.
The use of HS analysis results in a higher detection rate of prostate cancer compared to common transrectal ultrasonography (TRUS)-guided Bx. This technique increases the informative value of TRUS imaging and improves the diagnostic impact at least in the targeted biopsy setting.
现代成像方式改善了前列腺疾病的诊断。
本研究旨在利用组织扫描（HistoScanning™，HS）分析结果来确定会阴模板引导下前列腺穿刺活检患者中用于识别前列腺癌（PCa）的穿刺活检程序的结果特征。
共有104名连续入选的男性（平均年龄69岁，平均前列腺特异性抗原[PSA]为9.9 ng/ml）在进行扩展前列腺穿刺活检程序前接受了HS检查。患者接受了靶向经会阴（模板辅助）以及靶向经直肠前列腺穿刺活检，使用HS投影报告，并辅以标准化的14针系统经直肠前列腺穿刺活检（Bx）。在扇区水平分析癌症检出率，并将HS靶向结果与活检结果、敏感性、特异性、预测准确性、阴性预测值（NPV）和阳性预测值（PPV）相关联。
104例患者中，44例（42%）被发现患有PCa。组织学检查分别在3例患者（2.9%）中检测到非典型小腺泡增生，16例（15.4%）中检测到高级别前列腺上皮内瘤变，74例（71.1%）中检测到慢性活动性炎症。与Bx相比，HS靶向活检中每个区域的检出率显著更高。尽管靶向活检方法活检的区域数量较少，但每位患者的检出率没有显著差异。扇区水平的总体敏感性、特异性、预测准确性、NPV和PPV分别为37.2%、85.6%、78.6%、88.7%和第30.8%。
与普通经直肠超声（TRUS）引导下的Bx相比，使用HS分析可提高前列腺癌的检出率。该技术增加了TRUS成像的信息量，并至少在靶向活检环境中改善了诊断效果。
