Mehmood K, Mubarak M, Dhar M, Rafi M, Kinsella J
Sindh Institute of Urology and Transplantation, Departments of Radiology, Karachi-74200, Pakistan.
Malays J Pathol. 2017 Dec;39(3):285-288.
Traditionally, transrectal ultrasound (TRUS)-guided biopsies are done for the diagnosis of prostate cancer (PCa) in Pakistan. The transperineal template-guided saturation biopsy (TTSB) approach has been recently introduced in Pakistan and we share diagnostic yields and pathological findings of specimens taken for PCa diagnosis in men with elevated serum total prostate specific antigen (PSA) and negative TRUS-guided prostate biopsies. In all, 16 patients investigated at the Department of Urology, Sindh Institute of Urology and Transplantation (SIUT), underwent TTSB. The mean age of patients was 67.8 ± 8.8 (range: 55 - 84) years. The median PSA was 9.5 (IQR: 7.9 - 19.8) ng/ ml. The duration of symptoms before biopsy ranged from 1 month to 144 months. The prostate was enlarged with mean weight of 73.5 ± 55.5 g. Histopathology revealed PCa in 5 of 16 (31.2%) cases. The Gleason score was 6 (3+3), 7 (3+4) and 8 (4+4) in 1 case each (6.3%) and 10 (5+5) in 2 cases (12.5%). At least two cores were positive in all positive cases. None of the patients required antibiotics post-procedure. In conclusion, the TTSB technique is a promising option for patients with elevated PSA level and negative transrectal prostate biopsies for the detection of PCa in our setting.
传统上，在巴基斯坦，经直肠超声（TRUS）引导下的活检用于前列腺癌（PCa）的诊断。经会阴模板引导下的饱和活检（TTSB）方法最近已引入巴基斯坦，我们分享了血清总前列腺特异性抗原（PSA）升高且TRUS引导下前列腺活检阴性的男性患者中用于PCa诊断的标本的诊断率和病理结果。总共16例在信德省泌尿学和移植研究所（SIUT）泌尿外科接受检查的患者接受了TTSB。患者的平均年龄为67.8±8.8（范围：55 - 84）岁。PSA中位数为9.5（四分位间距：7.9 - 19.8）ng/ml。活检前症状持续时间为1个月至144个月。前列腺增大，平均重量为73.5±55.5 g。组织病理学显示16例中有5例（31.2%）为PCa。Gleason评分6（3 + 3）、7（3 + 4）和8（4 + 4）各1例（6.3%），10（5 + 5）2例（12.5%）。所有阳性病例中至少有两个核心为阳性。术后没有患者需要使用抗生素。总之，对于我们这里PSA水平升高且经直肠前列腺活检阴性的患者，TTSB技术是检测PCa的一种有前景的选择。
