Ornstein D K, Rao G S, Smith D S, Andriole G L
Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
J Urol. 1997 Mar;157(3):880-3; discussion 883-4.
We determined the impact of 1 or more systematic (4 to 6 cores) needle biopsies of the prostate on the incidence of prostate cancer in men undergoing transurethral resection of the prostate for symptomatic benign prostatic hyperplasia (BPH) with elevated serum prostate specific antigen (PSA) and/or suspicious digital rectal examination.
Records were reviewed retrospectively for 85 consecutive men 54 to 85 years old who underwent transurethral resection of the prostate for symptomatic BPH. Of the men 56 (66%) had at least 1 prior benign systematic prostate biopsy.
Cancer was detected in the transurethral resection specimen in 5 of 29 men (17.2%) who had no prior prostatic biopsy and in 9 of 56 (16.1%) who had at least 1 prior benign biopsy. Among the latter group the probability of cancer being present in the transurethral resection specimen was not related to the number of prior biopsies, PSA concentration or PSA density. Of the cancers detected in men with at least 1 prior benign biopsy 89% were clinical stage T1b or greater.
Clinically relevant prostate cancers may be detected in a significant proportion (more than 15%) of men undergoing transurethral resection of the prostate for symptomatic BPH despite prior screening with serum PSA, digital rectal examination and 1 or more systematic needle biopsies of the prostate.
我们确定了对因有症状的良性前列腺增生（BPH）且血清前列腺特异性抗原（PSA）升高和/或直肠指检可疑而接受经尿道前列腺切除术的男性进行1次或多次系统性（4至6针）前列腺穿刺活检对前列腺癌发病率的影响。
回顾性分析85例年龄在54至85岁之间因有症状的BPH接受经尿道前列腺切除术的男性患者的记录。其中56例（66%）男性此前至少接受过1次良性系统性前列腺穿刺活检。
在29例未曾接受过前列腺穿刺活检的男性经尿道切除标本中发现5例（17.2%）患有癌症，在56例至少接受过1次良性穿刺活检的男性中9例（16.1%）患有癌症。在后一组中，经尿道切除标本中存在癌症的可能性与既往穿刺活检次数、PSA浓度或PSA密度无关。在至少接受过1次良性穿刺活检的男性中检测到的癌症，89%为临床分期T1b或更高。
尽管此前进行了血清PSA检测、直肠指检以及1次或多次系统性前列腺穿刺活检，但在因有症状的BPH接受经尿道前列腺切除术的男性中，仍有相当比例（超过15%）可检测到临床相关的前列腺癌。
