Panach-Navarrete J, García-Morata F, Valls-González L, Martínez-Jabaloyas J M
Servicio de Urología. Hospital Clínico Universitario de Valencia, Valencia, España.
Servicio de Urología. Hospital Clínico Universitario de Valencia, Valencia, España.
Actas Urol Esp. 2016 May;40(4):224-8. doi: 10.1016/j.acuro.2015.10.006. Epub 2015 Nov 24.
Prostate cores from transrectal biopsies are usually sent in separate vials for pathological processing. Although this is a common practice, there are controversial studies on its usefulness. We wanted to compare the rate of prostate cancer diagnosis between processing samples in 2 containers and processing them in individual containers to see if there are differences. Our secondary objective was to check the rate of diagnosis of various tumour subtypes in each of the 2 groups.
A retrospective observational study was conducted of 2,601 cases of prostate biopsies. Ten cores were extracted in each biopsy. We divided the sample into 2 groups: biopsies sent in 2 containers to the department of pathology (left and right lobes) or sent in 10 (one for each cylinder), according to the different criteria used in our centre in the past. We then classified the cases according to the absence of neoplasia, insignificant tumour (involvement of just 1 cylinder, <5%, Gleason score<7), Gleason 6 or Gleason≥7. A bivariate statistical analysis was performed using the chi-squared test.
A total of 1,777 participants were included in the 2-container group, and 824 were included in the 10-container group. We diagnosed a rate of 32.4% of cancers in the 2-container group and 40% in the 10-container group, a difference that was statistically significant (P<.001). The insignificant carcinomas were diagnosed more often in the 2-container group than in the 10-container group (6.4% vs. 4.3%, respectively; P=.03). Samples with a Gleason score of 6 were diagnosed more often in the 10-container group than in the 2-container group (11.9% vs. 8.1%, respectively; P=.002). The same occurred with the Gleason score≥7 (23.8% in the 10-container group vs. 17.9% in the 2-container group; P<.001).
We diagnosed more prostate cancers when sending biopsied cores in individual containers. Once the procedure was conducted, we also observed in our series a reduction in the diagnoses of insignificant carcinoma to the detriment of an increased diagnosis of not insignificant carcinomas.
经直肠活检获取的前列腺组织条通常被分别置于不同小瓶中进行病理处理。尽管这是一种常见做法，但关于其有效性存在争议性研究。我们想要比较将样本置于2个容器中处理与置于单个容器中处理时前列腺癌的诊断率，以查看是否存在差异。我们的次要目标是检查两组中各种肿瘤亚型的诊断率。
对2601例前列腺活检病例进行了一项回顾性观察研究。每次活检提取10条组织条。根据我们中心过去使用的不同标准，我们将样本分为两组：按照送至病理科的方式分为置于2个容器中（左右叶）或置于10个容器中（每个条一个容器）。然后我们根据是否存在肿瘤、微小肿瘤（仅累及1个条，<5%，Gleason评分<7）、Gleason 6或Gleason≥7对病例进行分类。使用卡方检验进行双变量统计分析。
2个容器组共纳入1777名参与者，10个容器组纳入824名参与者。我们在2个容器组中诊断出癌症的比例为32.4%，在10个容器组中为40%，差异具有统计学意义（P<.001）。微小癌在2个容器组中的诊断频率高于10个容器组（分别为6.4%和4.3%；P=.03）。Gleason评分为6的样本在10个容器组中的诊断频率高于2个容器组（分别为11.9%和8.1%；P=.002）。Gleason评分≥7的情况也是如此（10个容器组为23.8%，2个容器组为17.9%；P<.001）。
当将活检组织条置于单个容器中送检时，我们诊断出的前列腺癌更多。在进行该操作后，我们在本系列研究中还观察到微小癌的诊断减少，而有意义癌的诊断增加。
