Keetch D W, Catalona W J
Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
J Urol. 1995 Nov;154(5):1795-7.
In men with persistently elevated serum prostate specific antigen (PSA) concentrations and prostatic biopsies that show no cancer an important question is whether the PSA elevation is caused by undetected cancer in the transition zone of the prostate gland.
To evaluate this issue further we examined 166 men age 50 years of older who participated in a PSA based screening trial for prostate cancer. All men had an initially elevated serum PSA concentration of 4.1 ng./ml. or greater. They had undergone 1 or 2 sets of negative peripheral zone biopsies of the prostate but elevated serum PSA concentrations persisted. They underwent repeat biopsy of the peripheral zone as well as 2 core biopsies from the right and 2 from the left transition zone region of the prostate.
Peripheral and transition zone biopsies revealed cancer in 3 of 19 cases (16%). Cancer was present in the peripheral zone only biopsy in 14 of 19 cases (74%). Two of 19 cancers (10%) were detected only in the transition zone. Overall 17 of the 19 cancers (89%) were detected by peripheral zone biopsy.
Transition zone biopsy detects few additional prostate cancers in men with persistent serum PSA elevations and previous negative biopsies.
对于血清前列腺特异性抗原（PSA）浓度持续升高且前列腺活检未发现癌症的男性，一个重要问题是PSA升高是否由前列腺移行带未被检测到的癌症引起。
为进一步评估该问题，我们检查了166名年龄在50岁及以上、参与基于PSA的前列腺癌筛查试验的男性。所有男性的血清PSA初始浓度均升高至4.1纳克/毫升或更高。他们接受了1或2组前列腺外周带活检结果均为阴性，但血清PSA浓度仍持续升高。他们接受了外周带重复活检以及从前列腺右侧和左侧移行带区域各取2块芯针活检。
外周带和移行带活检在19例中有3例（16%）发现癌症。19例中有14例（74%）仅在外周带活检中发现癌症。19例癌症中有2例（10%）仅在移行带被检测到。总体而言，19例癌症中有17例（（89%）通过外周带活检被检测到。
对于血清PSA持续升高且先前活检为阴性的男性，移行带活检仅能检测到少数额外的前列腺癌。
