The accuracy of template-guided transperineal prostate biopsy evaluated by radical prostatectomy specimens
10.3760/cma.j.issn.1000-6702.2018.01.004
- VernacularTitle:根治性前列腺切除术后病理检查对模板引导下经会阴前列腺穿刺活检准确性的再评估
- Author:
Yu XIAO
1
;
Zhipeng MAI
;
Weigang YAN
;
Yi ZHOU
;
Zhien ZHOU
;
Zhiyong LIANG
;
Zhigang JI
;
Hanzhong LI
Author Information
1. 100730,中国医学科学院北京协和医院病理科
- Keywords:
Biopsy;
Transperineal;
Radical prostatectomy;
Focal therapy
- From:
Chinese Journal of Urology
2018;39(1):14-18
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the diagnostic value of template-guided transperineal prostate biopsy (TTPB) by comparing biopsy-derived pathological results with findings from radical prostatectomy (RP) specimens.Methods From April 2013 to December 2015,patients who were diagnosed prostate cancer by transperineal template-guided 11-region prostate biopsy were enrolled in our study,and underwent laparoscopic RP.All whole-mount slices were reconstructed via a three-dimensional prostate model.Pathological features of the biopsy and RP specimens were compared.Detection rate of index lesions,overall sensitivity and specificity of TTPB,Gleason scores (GSs) in comparisons of biopsy and RP specimens were analyzed.Results One hundred and three patients were enrolled in our study,and the mean age was (65 ± 6)years.The median serum PSA was 11.7 ng/ml(IQR 7.2-19.1 ng/ml).The Gleason score ranged from 6 to 9.The clinical stage was T1c-T3a and the median prostate volume was 33.0 ml(IQR 26.0-43.0 ml).Eighty-nine of the 103 index lesions (86.4％) were detected by biopsy.The median volume was 1.2 ml (IQR 0.5-3.3 ml) and the mean maximum tumor length was (0.6 ± 0.4)cm.The overall sensitivity and specificity of the transperineal prostate biopsies were 53.3％ and 94.2％,respectively.RP-derived GSs were unchanged,upgraded and downgraded relative to the corresponding biopsy-derived GSs in 75 (72.8％),24 (23.3％) and 4 (3.9％) patients,respectively.Conclusions Stematic transperineal template-guided prostate biopsy could detect most of the index lesions.This biopsy approach was less able to determine tumour focal positioning and could only serve as a reference for guiding focal therapy.
