期刊
WORLD JOURNAL OF UROLOGY
卷 32, 期 2, 页码 341-346出版社
SPRINGER
DOI: 10.1007/s00345-012-0989-8
关键词
Diagnosis; Prostate biopsy; Prostatic neoplasms
To determine whether the addition of four paramedian peripheral and four lateral peripheral cores improves the cancer detection rate (CDR) of the extended 10-core biopsy scheme and which patients benefit most from such additional samples. One thousand and ninety-one consecutive patients scheduled for first ultrasound-guided transrectal prostate biopsy prospectively underwent a 18-core biopsy scheme, including the traditional sextant (6-core), 4 lateral peripheral (10-core), 4 paramedian peripheral (14-core) and additional 4 lateral peripheral cores (18-core). The CDR of the 6-, 10-, 14- and 18-core schemes was 33.1, 39.2, 41.6 and 41.8 %, respectively; the difference between the 10- and 6-core scheme reached significance (p < 0.005), whereas that between the 18- or 14- and the 10-core scheme did not. The percentage of tumors diagnosed on the sole basis of the 14-core scheme was significantly greater in patients with low PSA (a parts per thousand currency sign7.2 vs. > 7.2 ng/ml: 12.1 vs. 1.8 %; p < 0.0001), large prostate volume (a parts per thousand yen50 vs. < 50 cc: 3.4 vs. 9.1 %; p = 0.011) and particularly low PSA density (< 0.15 vs. a parts per thousand yen0.15: 15.9 vs. 1 %; p < 0.0001). The 18-core scheme did not provide diagnostic advantages in any patients' population. The addition of 4 lateral peripheral samples did not increase the CDR of the 10-core biopsy scheme. The addition of four paramedian peripheral samples was beneficial only in patients with PSA density < 0.15, in whom the 10-core scheme would have miss almost 16 % of tumors. Since more than half of our patients had low (< 0.15) PSA density, these findings seem to be of great clinical relevance.
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