Konyalioglu Ersin, Tarhan Huseyin, Cakmak Ozgur, Pala Emel Ebru, Zorlu Ferruh
Department of Urology, Milas 75. Yil State Hospital, Mugla, Turkey.
Department of Urology, Tepecik Research and Training Hospital, Izmir, Turkey.
Int Braz J Urol. 2015 May-Jun;41(3):442-8. doi: 10.1590/S1677-5538.IBJU.2014.0251.
Tumor diameter is a reliable parameter to estimate tumor volume in solid organ cancers; its use in prostate cancer is controversial since it exhibits a more irregular pattern of growth. This study aimed to examine the association between the tumor volume estimations based on transrectal ultrasound (TRUS) guided biopsy results and the tumor volume measured on the pathological specimen.
A total of 237 patients who underwent radical retropubic prostatectomy (RRP) were included in this retrospective study. The differences and correlations between cancer volume estimations based on TRUS guided biopsy findings and cancer volume estimations based on post-prostatectomy pathology specimens were examined. In addition, diagnostic value of TRUS guided biopsy-based volume estimations in order to predict clinically significant cancer (>0.5 cc) were calculated.
The mean cancer volume estimated using TRUS biopsy results was lower (5.5±6.5 cc) than the mean cancer volume calculated using prostatectomy specimens (6.4±7.6 cc) (p<0.041).TRUS guided biopsy examination resulted in 5 false positive and 15 false negative cases. There was a significant but weak correlation between the two parameters (r=0.62, p<0.001). The sensitivity and specificity of TRUS guided biopsy in predicting the presence of clinically significant cancer was 93.4% (95% CI, 89.1-96.1) and 50.0% (95% CI, 20.1-79.9), respectively.
TRUS guided biopsy-derived estimations seem to have a limited value to predict pathologically established tumor volume. Further studies are warranted to identify additional methods that may more accurately predict actual pathological characteristics and prognosis of prostate cancer.
肿瘤直径是估计实体器官癌肿瘤体积的可靠参数；其在前列腺癌中的应用存在争议，因为前列腺癌表现出更不规则的生长模式。本研究旨在探讨经直肠超声（TRUS）引导下活检结果所估计的肿瘤体积与病理标本上测量的肿瘤体积之间的关联。
本回顾性研究纳入了237例行耻骨后根治性前列腺切除术（RRP）的患者。研究了基于TRUS引导活检结果的癌体积估计值与基于前列腺切除术后病理标本的癌体积估计值之间的差异和相关性。此外，还计算了基于TRUS引导活检的体积估计值对预测临床显著癌（>0.5 cc）的诊断价值。
使用TRUS活检结果估计的平均癌体积（5.5±6.5 cc）低于使用前列腺切除标本计算的平均癌体积（6.4±7.6 cc）（p<0.041）。TRUS引导活检检查导致5例假阳性和15例假阴性病例。这两个参数之间存在显著但较弱的相关性（r=0.62，p<0.001）。TRUS引导活检预测临床显著癌存在的敏感性和特异性分别为93.4%（95%CI，89.1-96.1）和50.0%（95%CI，20.1-79.9）。
TRUS引导活检得出的估计值在预测病理确定的肿瘤体积方面似乎价值有限。有必要进行进一步研究以确定可能更准确预测前列腺癌实际病理特征和预后的其他方法。
