From the Department of Surgery (Rabah, Khan), College of Medicine; from the Cancer Research Chair (Rabah, Arafa, Farhat), King Saud University, and from the Department of Urology (Rabah, Al-Taweel, Mokhtar), King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia.
Saudi Med J. 2021 Jun;42(6):649-654. doi: 10.15537/smj.2021.42.6.20200771.
To compare transperineal biopsies (TPBx) with transrectal ultrasound-guided biopsy (TRUSBx) in order to provide evidence, making clinicians able to select the appropriate biopsy approach under different conditions.
A comparative prospective study, conducted in King Khalid University Hospital (KKUH) and King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, Kingdom of Saudi Arabia, between March 2019 and February 2020. All patients with raised prostate-specific antigen or atypical digital rectal examination findings were subjected to multi-parametric magnetic resonance imaging (MRI). Those with positive findings were referred to targeted fusion- guided biopsy either TPBx or TRUSBx, randomly. Complication rate, cancer detection rate, and procedure time were recorded.
Transperineal biopsies and TRUSBx had an equivalent complication rate. However, both case detection rate and clinically significant cancer detection rate were significantly higher in TPBx versus TRUSBx (45.1% versus 29.1%, =0.003; and 71.8% versus 43.7%, =0.002; respectively). Transperineal biopsies was a longer procedure than TRUSBx (41.2±0.7 min versus 13±2.3 min, =0.0001).
No difference in complication rate was detected between the 2 procedures; however, TPBx was more effective for cancer detection in general and clinically significant cancer detection in particular.
比较经会阴活检（TPBx）与经直肠超声引导活检（TRUSBx），为临床医生在不同情况下选择合适的活检方法提供依据。
这是一项在沙特阿拉伯利雅得的 King Khalid 大学医院（KKUH）和 King Faisal 专科治疗与研究中心（KFSH&RC）进行的比较前瞻性研究，时间为 2019 年 3 月至 2020 年 2 月。所有前列腺特异性抗原升高或直肠指检异常的患者均接受多参数磁共振成像（MRI）检查。MRI 阳性的患者被随机转诊至行靶向融合引导活检，包括 TPBx 或 TRUSBx。记录并发症发生率、癌症检出率和操作时间。
经会阴活检和经直肠超声引导活检的并发症发生率相当。然而，与 TRUSBx 相比，TPBx 的癌症检出率和临床显著癌症检出率均显著更高（45.1%比 29.1%，=0.003；71.8%比 43.7%，=0.002）。TPBx 的操作时间长于 TRUSBx（41.2±0.7 分钟比 13±2.3 分钟，=0.0001）。
两种方法的并发症发生率无差异；然而，TPBx 总体上更有效检测癌症，特别是临床显著癌症。
