Yılmaz Hasan, Yavuz Ufuk, Üstüner Murat, Çiftçi Seyfettin, Yaşar Hikmet, Müezzinoğlu Bahar, Uslubaş Ali Kemal, Dillioğlugil Özdal
Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey.
Clinic of Urology, Karaman State Hospital, Karaman, Turkey.
Turk J Urol. 2017 Sep;43(3):297-302. doi: 10.5152/tud.2017.03743. Epub 2017 Jul 31.
Only a few papers in the literature aimed to evaluate biopsy core lengths. Additionally, studies evaluated the core length with different approaches. We aimed to determine whether prostate cancer (PCa) detection is affected from core lengths according to three different approaches in a large standard cohort and compare our cut-off values with the published cut-offs.
We retrospectively analyzed 1,523 initial consecutive transrectal ultrasound-guided 12-core prostate biopsies. Biopsies were evaluated with respect to total core length (total length of each patients' core) average core length (total core length divided by total number of cores in each patient), and mean core length (mean length of all cores pooled), and compared our cut-off values with the published cut-offs. The prostate volumes were categorized into four groups (<30, 30-59.99, 60-119.99, ≥120 cm) and PCa detection rates in these categories were examined.
PCa was found in 41.5% patients. There was no difference between benign and malignant mean core lengths of the pooled cores (p>0.05). Total core length and average core length were not significantly associated with PCa in multivariate logistic regression analyses (p>0.05). The core lengths (mean, average and total core lengths) increased (p<0.001) and PCa rates decreased (p<0.001) steadily with increasing prostate volume categories. PCa percentages decreased in all categories above the utilized cut-offs for mean (p>0.05), average (p<0.05), and total core lengths (p>0.05).
There was no difference between mean core lengths of benign and malignant cores. Total core length and average core length were not significantly associated with PCa. Contrary to the cut-offs used for mean and average core lengths in the published studies, PCa rates decrease as these core lengths increase. Larger studies are necessary for the determination and acceptance of accurate cut-offs.
文献中仅有少数论文旨在评估活检芯长度。此外，各项研究采用不同方法评估芯长度。我们旨在根据三种不同方法，在一个大型标准队列中确定前列腺癌（PCa）检测是否受芯长度影响，并将我们的截断值与已发表的截断值进行比较。
我们回顾性分析了1523例连续进行的初次经直肠超声引导下的12芯前列腺活检。从总芯长度（每位患者芯的总长度）、平均芯长度（总芯长度除以每位患者的芯总数）和平均芯长度（所有芯合并后的平均长度）方面对活检进行评估，并将我们的截断值与已发表的截断值进行比较。前列腺体积分为四组（<30、30 - 59.99、60 - 119.99、≥120 cm³），并检查这些组中的PCa检测率。
41.5%的患者被发现患有PCa。合并芯的良性和恶性平均芯长度之间无差异（p>0.05）。在多因素逻辑回归分析中，总芯长度和平均芯长度与PCa无显著相关性（p>0.05）。随着前列腺体积类别增加，芯长度（平均、平均和总芯长度）稳步增加（p<0.001），PCa率下降（p<0.001）。在平均（p>0.05）、平均（p<0.05）和总芯长度（p>0.05）高于所用截断值的所有类别中，PCa百分比均下降。
良性和恶性芯的平均芯长度之间无差异。总芯长度和平均芯长度与PCa无显著相关性。与已发表研究中用于平均和平均芯长度的截断值相反，随着这些芯长度增加，PCa率下降。需要进行更大规模的研究来确定和接受准确的截断值。
