Department of Urology, Jeroen Bosch Hospital, Post office box 90153, 5200 ME, 's-Hertogenbosch, The Netherlands.
Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.
World J Urol. 2018 Jun;36(6):863-869. doi: 10.1007/s00345-018-2209-7. Epub 2018 Feb 1.
To determine the value of a three-dimensional (3D) greyscale transrectal ultrasound (TRUS)-guided prostate biopsy system and biopsy core pre-embedding method on concordance between Gleason scores of needle biopsies and radical prostatectomy (RP) specimens.
Retrospective analysis of prostate biopsies and subsequent RP for PCa in the Jeroen Bosch Hospital, the Netherlands, from 2007 to 2016. Two cohorts were analysed: conventional 2D TRUS-guided biopsies and RP (2007-2013, n = 266) versus 3D TRUS-guided biopsies with pre-embedding (2013-2016, n = 129). The impact of 3D TRUS-guidance with pre-embedding on Gleason score (GS) concordance between biopsy and RP was evaluated using the κ-coefficient. Predictors of biopsy GS 6 upgrading were assessed using logistic regression models.
Gleason concordance was comparable between the two cohorts with a κ = 0.44 for the 3D cohort, compared to κ = 0.42 for the 2D cohort. 3D TRUS-guidance with pre-embedding, did not significantly affect the risk of biopsy GS 6 upgrading in univariate and multivariate analysis.
3D TRUS-guidance with biopsy core pre-embedding did not improve Gleason concordance. Improved detection techniques are needed for recognition of low-grade disease upgrading.
确定三维（3D）灰阶经直肠超声（TRUS）引导下前列腺活检系统和活检芯预包埋方法在经直肠超声引导前列腺活检和根治性前列腺切除术（RP）标本之间格里森评分一致性的价值。
回顾性分析 2007 年至 2016 年荷兰 Jeroen Bosch 医院的前列腺活检和随后的前列腺癌 RP。分析了两组：传统的 2D TRUS 引导活检和 RP（2007-2013，n=266）与 3D TRUS 引导活检和预包埋（2013-2016，n=129）。使用κ系数评估 3D TRUS 引导活检与预包埋对活检和 RP 之间格里森评分（GS）一致性的影响。使用逻辑回归模型评估活检 GS 6 升级的预测因子。
两组之间的格里森一致性相当，3D 组的κ值为 0.44，2D 组的κ值为 0.42。在单因素和多因素分析中，3D TRUS 引导活检与预包埋并没有显著影响活检 GS 6 升级的风险。
3D TRUS 引导活检芯预包埋并没有改善格里森一致性。需要改进检测技术以识别低级别疾病的升级。
