Tei Hiromoto, Miyake Hideaki, Harada Ken-Ichi, Fujisawa Masato
Division of Urology, Kobe University Graduate School of Medicine, Kobe, Japan.
Curr Urol. 2015 Jul;8(2):91-5. doi: 10.1159/000365696. Epub 2015 Jul 10.
To analyze the diagnostic performance of 12-core biopsy in detecting significant prostate cancer (PCa).
Thisstudy included 206 PCa patients who underwent transrectal 12-core biopsy followed by radical prostatectomy. Radical prostatectomy specimens were anatomically divided into 12 areas according to the sampling cores, and the existence of significant cancer, defined by a tumor volume > 0.5 ml, was investigated. The detection rate of significant cancer in each area was calculated as follows: the number of positive core biopsies/the number of areas containing significant cancer × 100.
The overall detection rate of significant cancer in all areas was 53.6%. The detection rate was significantly higher in the standard sextant cores than in the additional 6 cores in patients with prostate-specific antigen ≥ 10 ng/ml, clinical stage ≥ T2, or biopsy Gleason score ≥ 7, but not in those with prostate-specific antigen < 10 ng/ml, clinical stage T1c, or biopsy Gleason score ≤ 6.
Approximately half of the significant cancers were not accurately detected, and the detection rates in biopsy cores other than the sextant cores appeared to be significantly lower in PCa patients with aggressive features.
分析12针活检在检测显著前列腺癌(PCa)中的诊断性能。
本研究纳入了206例行经直肠12针活检随后行根治性前列腺切除术的PCa患者。将根治性前列腺切除标本根据取材针道在解剖学上分为12个区域,并研究肿瘤体积>0.5 ml定义的显著癌的存在情况。各区域显著癌的检出率计算如下:阳性活检针数/含有显著癌的区域数×100。
所有区域显著癌的总体检出率为53.6%。在前列腺特异性抗原≥10 ng/ml、临床分期≥T2或活检Gleason评分≥7的患者中,标准六分区针道的检出率显著高于另外6针,但在前列腺特异性抗原<10 ng/ml、临床分期T1c或活检Gleason评分≤6的患者中并非如此。
约一半的显著癌未被准确检测到,在具有侵袭性特征的PCa患者中,除六分区针道外的活检针道的检出率似乎显著较低。