背景:本研究旨在调查临床怀疑前列腺癌(PCa)但活检前多参数磁共振成像阴性的男性进行系统活检(SB)所需的核数量,并测试前列腺特异性抗原(PSA)密度作为SB降低的指标。
方法:对二百七十四例患者进行分析,从机构数据库中提取。通过使用Fisher精确检验,比较了不同减少活检方案中任何PCa和临床意义(CS)PCa的检出率。
结果:总计,12核SB在103名男性(37.6%)中显示PCa。减少活检方案的检出率为74(27%,6核)和82核(29.9%,8核)。关于CSPCa,12核SB的检出率为26(9.5%)。减少活检方案检测到较少的CSPCa:15(5.5%)和18(6.6%),分别。所有差异均有统计学意义,p<0.05。PSA密度≥0.15无助于筛选出活检减少可能就足够的男性。
结论:与减少活检方案相比,十二核SB在所有PCa和CSPCa中仍具有最高的检出率。如果研究者和患者同意-基于个人风险计算-进行活检,无论PSA密度如何,该SB应包含至少12个芯。
BACKGROUND: This study aimed to investigate the number of cores needed in a systematic biopsy (SB) in men with clinical suspicion of prostate cancer (PCa) but negative prebiopsy multiparametric magnetic resonance imaging and to test prostate-specific antigen (PSA) density as an indicator for reduced SB.
METHODS: Two hundred and seventy-four patients were analyzed, extracted from an institutional database. Detection rates of any PCa and clinically significant (CS) PCa for different reduced biopsy protocols were compared by using Fisher\'s exact test.
RESULTS: In total, 12-core SB revealed PCa in 103 (37.6%) men. Detection rates of reduced biopsy protocols were 74 (27%, 6-core) and 82 (29.9%, 8-core). Regarding CSPCa, 12-core SB revealed a detection rate of 26 (9.5%). Reduced biopsy protocols detected less CSPCa: 15 (5.5%) and 18 (6.6%), respectively. All differences were statistically significant, p < 0.05. PSA density ≥0.15 did not help to filter out men in whom a reduced biopsy may be sufficient.
CONCLUSIONS: Twelve-core SB still has the highest detection rate of any PCa and CSPCa compared to reduced biopsy protocols. If the investigator and patient agree - based on individual risk calculation - to perform a biopsy, this SB should contain at least 12 cores regardless of PSA density.