Clinical analysis of systematic 12 + 1-core biopsy of prostate cancer detected by transrectal ultrasound resonance guided prostate system
10.3760/cma.j.issn.1000-6702.2017.05.014
- VernacularTitle:经直肠超声引导前列腺12+1针穿刺活检的临床研究
- Author:
Yuxiao ZHENG
;
Cheng ZHANG
;
Jie WU
;
Yuan HUANG
;
Gong CHENG
;
Lixin HUA
- Keywords:
Prostate cancer;
Prostate biopsy;
Transrectun ultrasound;
Magnetic resonance imaging
- From:
Chinese Journal of Urology
2017;38(5):375-378
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the dijference of prostate cancer detection rate (PCDR) between 12 + 1-core biopsy and 6-core biopsy of the prostate system guided by transrectal ultrasonography (TRUS).Methods The clinical data of 2 707 patients with prostate biopsy from July 1999 to June 2012 were retrospectively analyzed.These patients were 54 to 92 years old,mean age was 69 years old.The range of PSA was 0.02-158.56 ng/ml,with an average of 16.97 ng/mt.People in the range of PSA 0-4.00,4.01-10.00,10.01-20.00,20.01-30.00,and ＞ 30.00 were 161,826,827,312,581,respectively.The volume of the prostate ranged from 14.1 to 82.6 cm3,mean 47.9 cm3.The 1 603 cases before the July 2009 were performed 6-core biopsy guided by the finger,followed by 1104 TRUS-guided 12 + 1-core biopsy.In addition,after March 2012,60 patients accepeted the MRI examination before prostate biopsy.The strategy of prostate biopsy was medial 6-core,lateral 6-core,the 13th core was positioned at abnormal signal area of TRUS and MRI.Explore the difference of PCDR medial 6-core,lateral 6-core,systematic 12-and 12 + 1-core,and the difference of 13th core and the other 12 cores,with the cut off value of PSA quartile of 30 ng/ml and PV quartile of 46 cm3.Results Comparison of clinical characteristics of prostate biopsy between positive group and negative group was performed,and the result suggested that The positive outcome of prostate cancer biopsy was related with element such as high PSA,old age [(71.7 ±7.1)vs.(68.3 ± 8.1),P =0.008],large fPSA [(8.5 ± 36.4) vs.(2.3 ± 3.4),P ＜ 0.001],small prostate volume [(41.3 ±22.9) vs.(52.3 ±29.3),P ＜0.001],small value of f/t[(0.12 ± 0.07) vs.(0.17 ±0.10,P ＜0.001)],high density of PSA [(2.04 ± 9.36) vs.(0.32 ± 0.42),P ＜ 0.001],digital rectal examination [72.0％ (522/725) vs.23.1％ (457/1 982),P ＜ 0.001],irregular echo level [41.1％ (695/1 693) vs.28.0％ (284/1 014),P ＜ 0.001],hypoechoic [64.3％ (695/1 081) vs.17.5％ (284/1 626),P ＜ 0.001],microcalcifcation[56.8％ (586/1 032) vs.23.5％ (393/ 675),P ＜ 0.001].PCDR of 12 + 1-core biopsy was significantly higher than lateral 6-core biopsy[41.5％ (458/1 104)vs.37.0％ (408/1 104),P =0.033].However,PCDR of 12-core biopsy had no statistical differences with 6-core biopsy[40.7％ (449/1 104) vs.37.0％ (408/1 104),P =0.081].PCDR of TRUS-guided biopsy was higher than that of finger-guided biopsy in patients with PSA≤30 ng/ml and PV ＞46 cm3 [30.0％ (254/846)vs.22.2％ (284/1 280),P ＜0.001;31.7％ (124/391)vs.18.1％ (131/723),P ＜0.001].PCDR of the 13th core positioned at abnormal signal area of TRUS and MRI was higher than the average PCDR of other 12 cores [70.9％ (107/151) vs.56.6％ (3 109/5 496),P ＜ 0.001].Conclusion PCDR of TRUS-guided biopsy was higher than that of finger-guided biopsy in patients with PSA≤30 ng/ml and PV ＞46 cm3.PCDR of 12 + 1-core biopsy was significantly higher than that of lateral 6-core biopsy.However,PCDR of 12-core biopsy had no statistical differences with that of 6-core biopsy.PCDR of the 13th core positioned at abnormal signal area of TRUS was higher than the average PCDR of other 12 cores.
