Lee Sangchul, Jeong Seong Jin, Hwang Sung Il, Hong Sung Kyu, Lee Hak Jong, Byun Seok Soo, Choe Gheeyoung, Lee Sang Eun
Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
PLoS One. 2015 Apr 14;10(4):e0123704. doi: 10.1371/journal.pone.0123704. eCollection 2015.
There is little data about the clinical value of core length for prostate biopsy (PBx). We investigated the clinical values of various clinicopathological biopsy-related parameters, including core length, in the contemporary multi-core PBx.
Medical records of 5,243 consecutive patients who received PBx at our institution were reviewed. Among them, 3,479 patients with prostate-specific antigen (PSA) ≤ 10 ng/ml level who received transrectal ultrasound (TRUS)-guided multi (≥ 12)-core PBx at our institution were analyzed for prostate cancer (PCa). Gleason score upgrading (GSU) was analyzed in 339 patients who were diagnosed with low-risk PCa and received radical prostatectomy. Multivariate logistic regression analyses for PCa detection and prediction of GSU were performed.
The mean age and PSA of the entire cohort were 63.5 years and 5.4 ng/ml, respectively. The overall cancer detection rate was 28.5%. There was no statistical difference in core length between patients diagnosed with PCa and those without PCa (16.1 ± 1.8 vs 16.1 ± 1.9 mm, P = 0.945). The core length was also not significantly different (16.4 ± 1.7 vs 16.4 ± 1.6mm, P = 0.889) between the GSU group and non-GSU group. Multivariate logistic regression analyses demonstrated that the core length of PBx did not affect PCa detection in TRUS-guided multi-core PBx (P = 0.923) and was not prognostic for GSU in patients with low-risk PCa (P = 0.356).
In patients undergoing contemporary multi-core PBx, core length may not have significant impact on PCa detection and also GSU following radical prostatectomy among low-risk PCa group.
关于前列腺活检（PBx）核心长度的临床价值，相关数据较少。我们在当代多核心PBx中，研究了包括核心长度在内的各种临床病理活检相关参数的临床价值。
回顾了在我们机构接受PBx的5243例连续患者的病历。其中，对3479例前列腺特异性抗原（PSA）≤10 ng/ml且在我们机构接受经直肠超声（TRUS）引导下多（≥12）核心PBx的患者进行前列腺癌（PCa）分析。对339例被诊断为低风险PCa并接受根治性前列腺切除术的患者进行Gleason评分升级（GSU）分析。进行了PCa检测和GSU预测的多变量逻辑回归分析。
整个队列的平均年龄和PSA分别为63.5岁和5.4 ng/ml。总体癌症检出率为28.5%。诊断为PCa的患者与未诊断为PCa的患者在核心长度上无统计学差异（16.1±1.8 vs 16.1±1.9 mm，P = 0.945）。GSU组和非GSU组之间的核心长度也无显著差异（16.4±1.7 vs 16.4±1.6mm，P = 0.889）。多变量逻辑回归分析表明，PBx的核心长度在TRUS引导下的多核心PBx中不影响PCa检测（P = 0.923），在低风险PCa患者中对GSU无预后意义（P = 0.356）。
在接受当代多核心PBx的患者中，核心长度可能对PCa检测以及低风险PCa组根治性前列腺切除术后的GSU没有显著影响。
