Luan Yang, Xiao Qin, Ding Xue-Fei, Zhu Liang-Yong, Han Yue-Xing, Chen Hao-Peng, Huang Tian-Bao, Lu Sheng-Ming
Clinical Medical College, Yangzhou University, Yangzhou, China.
Front Oncol. 2022 Oct 14;12:983805. doi: 10.3389/fonc.2022.983805. eCollection 2022.
To explore the feasibility of single-point prostate biopsy in elderly patients with highly suspected prostate cancer.
Forty-three patients with a prostate imaging reporting and data system score (PI-RADS) of 5, age ≥ 80 years and/or PSA ≥ 100 ng/ml and/or Eastern Cooperative Oncology Group score ≥ 2 were enrolled in our hospital from March 2020 to June 2022. Targeted surgery of these patients was performed using only precise local anesthesia in the biopsy area. The biopsy tissues were examined by intraoperative frozen section examination (IFSE). If the result of IFSE was negative, traditional systematic biopsy and further routine pathological examination were performed. The positive rate of biopsy, operation time, complications and pain score were recorded.
The positive rate of prostate biopsy was 94.7%. The results of IFSE in two patients were negative, and the routine pathological results of further systematic biopsy of those patients were also negative. The visual analog scale and visual numeric scale were 2 (2-4) and 3 (2-3), respectively, during the biopsy procedure. The mean time of operation was 8.5 ± 2.1 min from the beginning of anesthesia to the end of biopsy. It took 35.3 ± 18.7 minutes to obtain the pathological report of IFSE. The incidences of complication hematuria and urinary retention were 10.5% and 2.6%, respectively.
For elderly patients with highly suspected prostate cancer, single-point prostate biopsy can be used to quickly and safely obtain pathological results.
探讨单点前列腺活检在高度怀疑前列腺癌的老年患者中的可行性。
选取2020年3月至2022年6月在我院就诊的43例前列腺影像报告和数据系统（PI-RADS）评分为5分、年龄≥80岁和/或前列腺特异性抗原（PSA）≥100 ng/ml和/或东部肿瘤协作组（ECOG）评分≥2分的患者。仅在活检区域使用精确局部麻醉对这些患者进行靶向手术。活检组织通过术中冰冻切片检查（IFSE）。如果IFSE结果为阴性，则进行传统的系统活检和进一步的常规病理检查。记录活检阳性率、手术时间、并发症和疼痛评分。
前列腺活检阳性率为94.7%。2例患者的IFSE结果为阴性，这些患者进一步系统活检的常规病理结果也为阴性。活检过程中视觉模拟量表（VAS）和视觉数字量表（VNS）评分分别为2（2-4）分和3（2-3）分。从麻醉开始到活检结束的平均手术时间为8.5±2.1分钟。获得IFSE病理报告需要35.3±18.7分钟。并发症血尿和尿潴留的发生率分别为10.5%和2.6%。
对于高度怀疑前列腺癌的老年患者，单点前列腺活检可用于快速、安全地获得病理结果。
