| Xiaojun Deng,Jian Chu,Bo Yang,Feng Liu,Weifeng Wang,Jidong Hao,Jiansheng Wan,Hui Liu. Is extended biopsy protocol justified in all patients with PSA ≥ 20 ng/mL?. Oncol Transl Med, 2014, 13: 422-426. |
| 扩大穿刺对PSA≥20ng/mL的患者合适吗？ |
| Is extended biopsy protocol justified in all patients with PSA ≥ 20 ng/mL? |
| Received:July 01, 2014 Revised:August 18, 2014 |
| DOI：10.1007/s10330-014-0017-0 |
| 中文关键词: 穿刺；前列腺癌；扩大；阳性率 |
| 英文关键词: biopsy; prostate cancer (PCa); extend; detection rate; prostate-specific antigen (PSA) |
| 基金项目:浦东新区卫生系统优秀青年医学人才培养计划，编号，PWRq2013-17；浦东新区周浦医院院级课题，编号：ZP-XM-2012B-22 |
| Author Name | Affiliation | E-mail | | Xiaojun Deng | Pudong New Area Zhoupu Hospital, Shanghai 201318, China | deng810729@126.com | | Jian Chu | The 411 Hospital of People's Liberation Army, Shanghai 200081, China | | | Bo Yang | Department of Urology, Pudong New Area Zhoupu Hospital, Shanghai 201318, China | | | Feng Liu | Department of Urology, Pudong New Area Zhoupu Hospital, Shanghai 201318, China | | | Weifeng Wang | Department of Urology, Pudong New Area Zhoupu Hospital, Shanghai 201318, China | | | Jidong Hao | Department of Urology, Pudong New Area Zhoupu Hospital, Shanghai 201318, China | | | Jiansheng Wan | Department of Urology, Pudong New Area Zhoupu Hospital, Shanghai 201318, China | | | Hui Liu* | Pudong New Area Zhoupu Hospital, Shanghai 201318, China | liuhui600706@126.com |
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| 中文摘要: |
| 目的：探讨是否有必要对PSA≥20ng/ml的患者采用扩大穿刺,和探寻一种合适的个体化经直肠前列腺穿刺方案。方法：对115例PSA≥20ng/ml的可疑前列腺癌的患者进行经直肠前列腺穿刺活检,随机分为两组分别采用“6 X”和“10 X”穿刺法进行经直肠前列腺穿刺活检,比较前列腺癌的阳性率、前列腺癌的特征、并发症及疼痛情况。结果：总体前列腺癌阳性率为73.9%。其中,当20ng/ml≤PSA ＜50 ng/ml, 相比“6 X”,“10 X”仅增加阳性率9.7%,当PSA≥50.1ng/ml,两组检测率相似,无统计学意义。但两组穿刺数目及疼痛评分有显著性差异(p<0.001)。结论：但PSA≥20ng/ml,扩大穿刺并不能明显增加阳性率,反而增加患者穿刺时的疼痛不适。 |
| 英文摘要: |
| Objective: The aim of this study was to investigate whether it was necessary to increase the number of cores at initial prostate biopsy with patients of prostate-specific antigen (PSA) ≥ 20 ng/mL and to explore an appropriate individualized
transrectal ultrasonograhpy (TRUS)-guided prostate biopsy for the detection of prostate cancer in men suspicious of prostate cancer. Methods: A total of 115 patients with PSA ≥ 20 ng/mL and suspicious of prostate cancer were prospectively randomized to perform TRUS-guided biopsy. Patients were randomized to a “6 X” cores or a “10 X” cores protocol. The primary end point was cancer detection rate. Secondary end points were cancer characteristics, rate of complications and the level of pain experienced by patients during TRUS-guided prostate biopsy. Results: Preoperative variables were similar in both groups. The overall prostate cancer detection rate was 73.9%. The “10 X” cores strategy increased cancer detection rate only 9.7% in patients with PSA ≥ 20 ng/mL but < 50 ng/mL, while there was no difference between the two strategies for cancer detection in patients with PSA ≥ 50.1 ng/mL. The number of extended biopsy cores and pain score of extended biopsy in prostate cancer patients increased significantly (P < 0.001). Conclusion: Our findings suggest that there is no significant advantage in using extended biopsy protocol in all patients with PSA ≥ 20 ng/mL. |
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