Individualization of the biopsy protocol according to the prostate gland volume for prostate cancer detection

被引:50
作者
Eskicorapci, SY [1 ]
Guliyev, F [1 ]
Akdogan, B [1 ]
Dogan, HS [1 ]
Ergen, A [1 ]
Ozen, H [1 ]
机构
[1] Hacettepe Univ, Sch Med, Dept Urol, Ankara, Turkey
关键词
prostate; biopsy; prostatic neoplasms; ultrasound; high-intensity focused; transrectal;
D O I
10.1097/01.ju.0000154242.60413.3d
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: In this study we assessed the relative yield of 10 core biopsy, and the whole range of alternative 8 and 6 core biopsy protocols over that of the classic sextant biopsy protocol. We determined the optimum number of cores per biopsy according to prostate volume in patients who experienced prostate biopsy for the first time. Materials and Methods: A total of 503 men with the indications of abnormal digital rectal examination and/or serum prostate specific antigen greater than 2.5 ng/ml were included in the study. All patients underwent a 10 core biopsy protocol with an additional 1 core from each suspicious area detected by transrectal ultrasound. Prostate volume was divided into quartiles, namely 14.9 to 35, 35.1 to 50, 50.1 to 65 and 65.1 to 150 cc. The optimum number of biopsy cores was determined in patients with different prostate volumes. Results: Median age was 63 years and prostate specific antigen was 7.4 ng/ml in the whole group. Of 503 patients 159 (31.6%) were positive for prostate cancer. Cancer detection rates decreased significantly from 49.6% to 20.8% as prostate volume increased in preset quartiles. Lesion biopsies revealed the lowest unique cancer detection rates for all prostate volume quartiles (0% to 3%). There was an obvious positive trend in cancer detection rates in favor of the 10 core biopsy protocol over sextant biopsies in all patient groups. Classic sextant biopsy protocol proved to be inadequate for all prostate volumes. Among sextant biopsy protocols laterally placed cores including the apex, lateral mid gland and lateral base had the best cancer detection rates (81% to 95%). The 8 core biopsy scheme consisting of the apex, mid gland, lateral mid gland and lateral base resulted in an only 1% lower detection rate (97%) than the 10 core biopsy protocol in the lowest quartile. The yield of the 10 core biopsy protocol in patients with a prostate volume of between 35.1 and 150 cc outscored that of the optimal 8 core biopsy scheme including the apex, base, lateral mid gland and lateral base with 3% to 8% differences in the cancer detection rate. Conclusions: The 10 core biopsy protocol must be used in all group of patients except patients with a prostate volume of 14.9 to 35 cc. In patients with a prostate volume of 14.9 to 35 cc the 8 core biopsy protocol consisting of the apex, mid gland, lateral mid gland and lateral base can be used since it revealed results similar to those of the 10 core biopsy protocol. The classic sextant biopsy protocol seemed inadequate for all prostate volumes. Patients with a larger prostate had lower cancer detection rates. Transrectal ultrasound directed lesion biopsies may be omitted when using 10 core biopsy protocols since the yield of these biopsies was less than 2%.
引用
收藏
页码:1536 / 1540
页数:5
相关论文
共 20 条
  • [1] Results of the 5 region prostate biopsy method: The repeat biopsy population
    Applewhite, JC
    Matlaga, BR
    McCullough, DL
    [J]. JOURNAL OF UROLOGY, 2002, 168 (02) : 500 - 503
  • [2] Three-dimensional computer-simulated prostate models: Lateral prostate biopsies increase the detection rate of prostate cancer
    Bauer, JJ
    Zeng, JC
    Weir, J
    Zhang, W
    Sesterhenn, IA
    Connelly, RR
    Mun, SK
    Moul, JW
    [J]. UROLOGY, 1999, 53 (05) : 961 - 967
  • [3] BEURTON D, 1997, BR J UROL, V80, P239
  • [4] Systematic 5 region prostate biopsy is superior to sextant method for diagnosing carcinoma of the prostate
    Eskew, LA
    Bare, RL
    McCullough, DL
    [J]. JOURNAL OF UROLOGY, 1997, 157 (01) : 199 - 202
  • [5] Validation of 2001 Partin tables in Turkey:: a multicenter study
    Eskicorapci, SY
    Karabulut, E
    Türkeri, L
    Baltaci, S
    Cal, C
    Toktas, G
    Akpinar, H
    Ozer, G
    Sozen, S
    Tokuc, R
    Lekili, M
    Soylu, A
    Albayrak, S
    Sahin, H
    Alpar, R
    Ozen, H
    [J]. EUROPEAN UROLOGY, 2005, 47 (02) : 185 - 189
  • [6] An extended 10-core transrectal ultrasonography guided prostate biopsy protocol improves the detection of prostate cancer
    Eskicorapci, SY
    Baydar, DE
    Akbal, C
    Sofikerim, M
    Günay, M
    Ekici, S
    Ozen, H
    [J]. EUROPEAN UROLOGY, 2004, 45 (04) : 444 - 448
  • [7] RANDOM SYSTEMATIC VERSUS DIRECTED ULTRASOUND GUIDED TRANS-RECTAL CORE BIOPSIES OF THE PROSTATE
    HODGE, KK
    MCNEAL, JE
    TERRIS, MK
    STAMEY, TA
    [J]. JOURNAL OF UROLOGY, 1989, 142 (01) : 71 - 75
  • [8] Outcome of sextant biopsy according to gland volume
    Karakiewicz, PI
    Bazinet, M
    Aprikian, AG
    Trudel, C
    Aronson, S
    Nachabe, M
    Peloquint, F
    Dessureault, J
    Goyal, MS
    Begin, LR
    Elhilali, MM
    [J]. UROLOGY, 1997, 49 (01) : 55 - 59
  • [9] The effect of prostate volume on the yield of needle biopsy
    Letran, JL
    Meyer, GE
    Loberiza, FR
    Brawer, MK
    [J]. JOURNAL OF UROLOGY, 1998, 160 (05) : 1718 - 1721
  • [10] The sextant protocol for ultrasound-guided core biopsies of the prostate underestimates the presence of cancer
    Norberg, M
    Egevad, L
    Holmberg, L
    Sparen, P
    Norlen, BJ
    Busch, C
    [J]. UROLOGY, 1997, 50 (04) : 562 - 566