Causes of missed diagnosis of clinically significant prostate cancer by targeted biopsy
10.13263/j.cnki.nja.2024.04.004
- VernacularTitle:靶向穿刺漏诊有临床意义前列腺癌的原因分析
- Author:
He-Song JIANG
1
;
Shan ZHOU
;
Xiao-Bing NIU
;
Lu JI
Author Information
1. 南京医科大学附属淮安第一医院泌尿外科,江苏 淮安 223300
- Keywords:
targeted biopsy;
clinically significant prostate cancer;
systematic biopsy;
missed diagnosis
- From:
National Journal of Andrology
2024;30(4):315-320
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To retrospectively analyze the causes of missed diagnosis of clinically significant PCa(csPCa)by targe-ted biopsy(TB).Methods:This retrospective study included 652 males aged(71.32±16.53)years with elevated PSA and ab-normal MRI signals detected in our hospital from June 2018 to December 2020.We further examined the patients by transperineal pros-tatic TB and systematic biopsy(SB),analyzed the detection rates of PCa and csPCa by TB and SB,and investigated the causes of missed diagnosis of csPCa in TB using the fishbone diagram.Results:The total detection rate of PCa and csPCa by TB combined with SB was 45.7%(298/652),and that of csPCa was 37.4%(244/652),with 38 cases of csPCa missed in TB,including 23 cases of negative TB and 15 cases of low ISUP grade.The causes of missed diagnosis of csPCa by TB included low MRI image quality,PSA density≤0.15 ng/ml/cm3,target area<10 mm,and PI-RADS 2 score≤3.The detection rate of csPCa by TB alone was 31.6%,which was increased by 5.8%(P=0.027)when TB combined with SB.Conclusion:TB combined with SB yields a higher de-tection rate of csPCa than either used alone.Missed diagnosis of csPCa by TB is closely related to the characteristics of tumor and MR image of the target area.
