Yoo Sangjun, Son Hwancheol, Oh Sohee, Park Juhyun, Cho Sung Yong, Cho Min Chul, Jeong Hyeon
Department of Urology, Seoul National University College of Medicine, Boramae Medical Center, Sindaebang 2(i)-Dong, Dongjak-gu, Seoul, 07061, Korea.
Department of Biostatistics, Seoul National University Boramae Medical Center, Seoul, Korea.
J Cancer Res Clin Oncol. 2018 Jan;144(1):135-143. doi: 10.1007/s00432-017-2525-0. Epub 2017 Sep 22.
To develop a novel biopsy-related parameter, named overlapping line, defined as the line between the adjacent positive cores on 12-core trans-rectal ultrasound-guided prostate biopsy, and evaluated the value of overlapping line for predicting tumor volume in the final pathologic examination.
Among patients with prostate cancer who underwent radical prostatectomy at Boramae Medical Center, 470 patients who underwent standard 12-core trans-rectal ultrasound-guided prostate biopsy were selected for the analysis. The number of overlapping line was determined in each patient, and its effects on tumor volume were evaluated after adjusting for other variables.
Median prostate specific antigen level was 9.1 ng/mL, and the maximum % cancer in positive cores was 42.8%. Median numbers of positive cores and overlapping lines were three and two, respectively. The pathologic stage was T2 or less, T3a, and T3b or greater in 297 (63.5%), 104 (22.2%), and 67 patients (14.3%), respectively. Median tumor volume in prostatectomy specimen was 3.4 mL. In multivariable analysis, the number of overlapping lines (B 0.750, p < 0.001) was a significant predictor for tumor volume, in addition to prostate specific antigen level and maximum % cancer in positive cores. In addition, the model with overlapping line showed superior accuracy compared to the model with positive core based adjusted r (0.467 vs. 0.456).
The number of overlapping lines, a novel prostate biopsy-related variable, is thought to be a more reliable predictor for tumor volume compared to the number of positive cores and could be easily applied to routine daily practice.
开发一种新的活检相关参数，称为重叠线，定义为在12针经直肠超声引导下前列腺活检中相邻阳性活检针芯之间的连线，并评估重叠线在最终病理检查中预测肿瘤体积的价值。
在博拉梅医疗中心接受根治性前列腺切除术的前列腺癌患者中，选择470例接受标准12针经直肠超声引导下前列腺活检的患者进行分析。确定每位患者的重叠线数量，并在调整其他变量后评估其对肿瘤体积的影响。
前列腺特异性抗原水平中位数为9.1 ng/mL，阳性活检针芯中的最大癌症百分比为42.8%。阳性活检针芯和重叠线的中位数分别为3个和2条。病理分期为T2及以下、T3a和T3b及以上的患者分别为297例（63.5%）、104例（22.2%）和67例（14.3%）。前列腺切除标本中的肿瘤体积中位数为3.4 mL。在多变量分析中，除前列腺特异性抗原水平和阳性活检针芯中的最大癌症百分比外，重叠线数量（B 0.750，p < 0.001）是肿瘤体积的显著预测指标。此外，与基于阳性活检针芯的模型相比，包含重叠线的模型显示出更高的准确性（调整后的r分别为0.467和0.456）。
重叠线数量作为一种新的前列腺活检相关变量，被认为是比阳性活检针芯数量更可靠的肿瘤体积预测指标，并且可以很容易地应用于日常临床实践。
