Fujioka T, Ishii N, Chiba R, Majima K, Numata I, Hakozaki H
Hinyokika Kiyo. 1984 Sep;30(9):1189-94.
We studied 35 needle aspiration biopsies of the prostatic cancer to evaluate the reliability for screening, as compared with the transrectal or transperineal needle biopsy of the same patients. Eight specimens were unsatisfactory for cytological study, only 77.4% of the 35 aspirations being cytologically evaluable. False negative aspiration biopsies occupied 22.7%. Histopathological evaluation was possible for all of the needle biopsies and the false negative rate was 5.7%. To examine how accurately aspiration biopsy or needle biopsy reflects the true histologic grade of prostatic cancer, both the cytologic grade of the aspirations and histologic grade of the biopsies were compared with the grade of the prostatectomy specimens. The aspiration biopsy was undergraded in 2 (11.8%) overgraded in 2 (11.8%) and correctly graded in 14 (82.4%) out of 17 cases. The needle biopsy was undergraded in 1 (3.2%), overgraded in 2 (6.5%) and correctly graded in 28 (90.3%) out of 31 cases. There was no significant difference in grading accuracy rate between cytology of the aspiration and histology of the needle biopsy. We conclude that the cytological grade is as reliable as needle biopsy, but aspiration biopsy is not a more efficient screening test for prostatic neoplasms than needle biopsy, considering the higher percentage of speciments unsatisfactory for aspiration and false negative in this small series.
我们研究了35例前列腺癌针吸活检,以评估其筛查的可靠性,并与同一患者的经直肠或经会阴针吸活检进行比较。8份标本不适合进行细胞学研究,35次针吸活检中只有77.4%可进行细胞学评估。假阴性针吸活检占22.7%。所有针吸活检均可进行组织病理学评估,假阴性率为5.7%。为了研究针吸活检或针吸穿刺活检反映前列腺癌真实组织学分级的准确性,将针吸活检的细胞学分级和穿刺活检的组织学分级与前列腺切除标本的分级进行了比较。在17例病例中,针吸活检分级过低的有2例(11.8%),分级过高的有2例(11.8%),分级正确的有14例(82.4%)。在31例病例中,针吸穿刺活检分级过低的有1例(3.2%),分级过高的有2例(6.5%),分级正确的有28例(90.3%)。针吸活检的细胞学分级和针吸穿刺活检的组织学分级在分级准确率上没有显著差异。我们得出结论,细胞学分级与针吸穿刺活检一样可靠,但考虑到在这个小样本系列中,针吸活检不满意标本的比例较高且假阴性率较高,针吸活检并非比针吸穿刺活检更有效的前列腺肿瘤筛查方法。