Maxim Laurian Ștefan, Rotaru Ruxandra Maria, Scârneciu Camelia Cornelia, Moga Marius Alexandru, Sabou Florin Lucian Petrică, Hogea Anda Catica, Gherasim Raul Dumitru, Ghicavîi Alexandru, Mulțescu Razvan-Dragos, Badea Mihail-Alexandru, Feciche Bogdan Ovidiu, Scârneciu Ioan
Emergency Clinical County Hospital Brasov, 500365 Brașov, Romania.
Faculty of Medicine, Transilvania University of Brasov, 500019 Brașov, Romania.
Diagnostics (Basel). 2025 Jul 31;15(15):1929. doi: 10.3390/diagnostics15151929.
To diagnose prostate cancer, a prostate biopsy is required. Two methods are commonly used for biopsy: transrectal and transperineal. The transperineal approach, particularly the "freehand" technique under local anesthesia, offers better access to the anterior prostate, lower infection risk, and higher detection rates. This retrospective study examined the records of 1674 patients who underwent ultrasound-guided prostate biopsies between 2015 and 2022. Of these, 1161 patients had transperineal biopsy using the "freehand" method, and 513 had transrectal biopsy. All the biopsies were carried out under local anesthesia, with a combined systematic and targeted approach for patients with MRI-identified lesions. This study demonstrates that the transperineal biopsy approach significantly increased the detection rate of clinically significant prostate cancer compared with the transrectal method, with detection rates of 65.7% and 59.4%, respectively. Notably, the transperineal technique also achieved superior detection of anteriorly located tumors (94.1% vs. 43.1%), supporting its use as the preferred biopsy strategy, particularly in anatomically challenging regions. Moreover, patients who underwent transperineal biopsy demonstrated more favorable diagnostic outcomes, characterized by a higher detection rate for clinically significant cancers and a reduced incidence of clinically insignificant cases. The transperineal method outperformed the transrectal approach, especially among younger patients and those presenting with lower PSA values. These results highlight the diagnostic superiority and broader clinical applicability of the transperineal biopsy technique across various patient subgroups.
要诊断前列腺癌，需要进行前列腺活检。活检通常使用两种方法：经直肠和经会阴。经会阴途径，特别是局部麻醉下的“徒手”技术，能更好地进入前列腺前部，感染风险更低，检出率更高。这项回顾性研究检查了2015年至2022年间接受超声引导下前列腺活检的1674例患者的记录。其中，1161例患者采用“徒手”方法进行经会阴活检，513例进行经直肠活检。所有活检均在局部麻醉下进行，对MRI识别出病变的患者采用系统和靶向相结合的方法。这项研究表明，与经直肠方法相比，经会阴活检方法显著提高了临床显著性前列腺癌的检出率，检出率分别为65.7%和59.4%。值得注意的是，经会阴技术对前部肿瘤的检出也更优（94.1%对43.1%），支持将其作为首选活检策略，特别是在解剖结构复杂的区域。此外，接受经会阴活检的患者显示出更有利的诊断结果，其特点是临床显著性癌症的检出率更高，临床无意义病例的发生率更低。经会阴方法优于经直肠方法，尤其是在年轻患者和PSA值较低的患者中。这些结果突出了经会阴活检技术在不同患者亚组中的诊断优越性和更广泛的临床适用性。
