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Low incidence of prostate cancer identified in the transition and anterior zones with transperineal biopsy

机译:经会阴穿刺活检在过渡区和前区发现的前列腺癌发生率低

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Purpose: Determine the incidence of anterior (AZ) and transition (TZ) zone prostate cancers using a transperineal mapping approach.Methods: A retrospective review of 137 patients with history of previous negative biopsy undergoing transperineal saturation biopsy for an elevated prostate-specific antigen (PSA), high-grade prostate intraepithelial neoplasia, atypical small acinar proliferation history, or abnormal digital rectal exam. The number of biopsy cores was determined by prostate volume and obtained using a predefined template. The electronic medical records were reviewed for patients' clinical and pathological characteristics.Results: Forty-one of 137 patients (31.4%) had positive biopsy for prostate adenocarcinoma; 11 were from 24-core, 19 from 36-core, and 11 from 48-core sampling. Glands > 45 mL had a mean of 1.7 previous biopsies and a PSA of 9.1 ng/mL. Glands < 30 mL were 1.3 and 6.3 ng/mL and glands 30–45 mL were 1.4 and 6.5 ng/mL. Glands < 45 mL had a higher number of positive biopsies per total cores. Seven patients chose active surveillance while 34 chose treatment. Of the 36- and 48-cores biopsies, 2.2% and 1.5%, respectively, were positive in the TZ. One patient was AZ-positive, 1 was TZ-positive, and 18 were peripheral zone (PZ)-positive alone. Twelve patients had cancer detected in PZ and TZ. Two patients developed urinary retention and one had a urine infection.Conclusion: Transperineal saturation biopsy is a safe and efficacious method of prostate cancer detection in patients with previous negative biopsy and high suspicion for cancer. Few cancers were found to originate in the TZ or AZ alone. We recommend that initial biopsy templates should sample PZ with less focus on the TZ.
机译:目的:使用经会阴作图方法确定前区(AZ)和过渡区(TZ)前列腺癌的发生率方法:回顾性分析137例既往有阴性活检史的患者,经过会阴饱和活检后发现前列腺特异性抗原升高( PSA),高级前列腺上皮内瘤变,非典型小腺泡增生史或直肠指检异常。活检核心数由前列腺体积决定,并使用预定模板获得。结果:137例患者中有41例(31.4%)前列腺癌的活组织检查为阳性。 11个来自24核,19个来自36核,11个来自48核采样。 ≥45 mL的腺体先前的活检平均为1.7,PSA为9.1 ng / mL。 <30 mL的腺体为1.3和6.3 ng / mL,30–45 mL的腺体为1.4和6.5 ng / mL。每个总芯中,<45 mL的腺体有更高数量的阳性活检。 7名患者选择了主动监护,而34名选择了治疗。在36芯和48芯活检中,TZ阳性分别为2.2%和1.5%。一名患者的AZ阳性,一名患者的TZ阳性,而18名患者的外周区(PZ)阳性。十二名患者在PZ和TZ发现了癌症。结论:会阴会阴穿刺活检是先前活检阴性且高度怀疑癌症的患者的一种安全有效的前列腺癌检测方法。发现很少有癌症单独起源于TZ或AZ。我们建议初始活检模板应以较少的TZ为重点对PZ进行采样。

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