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[An expanded technique of transrectal prostatic biopsy].
Urologiia (Moscow, Russia : 1999)
|April 30, 2004
Summary
Increasing transrectal prostatic biopsy sites significantly improves prostate cancer detection rates (PCDR), especially for localized cancers. Extended biopsy methods are crucial for accurate diagnosis, particularly in patients with lower PSA levels and larger prostates.
Area of Science:
- Urology
- Oncology
- Diagnostic Imaging
Background:
- Transrectal prostatic biopsy is a key diagnostic tool for prostate cancer.
- Optimizing biopsy site selection and number of samples is essential for improving diagnostic accuracy.
Purpose of the Study:
- To evaluate the diagnostic value of transrectal prostatic biopsy by comparing tissue sampling from different sites.
- To determine the impact of varying biopsy site numbers on prostate cancer detection rates (PCDR) across different prostate-specific antigen (PSA) levels and prostate sizes.
Main Methods:
- Primary transrectal biopsy was performed on 486 patients.
- Patients were stratified into 7 groups based on biopsy site numbers (6 to 18).
- Analysis focused on PCDR variations related to PSA levels (<20 ng/ml and >20 ng/ml) and prostate size (>50 cm³).
Main Results:
- For PSA < 20 ng/ml, increasing biopsy sites to 18 yielded a 16.6% rise in PCDR.
- In patients with PSA > 20 ng/ml, PCDR significantly increased by 9.3% when increasing biopsy sites from 6 to 12.
- Extended biopsy methods (18 sites) increased detection of local cancer forms from 70% to 92.3% in patients with PSA < 20 ng/ml.
Conclusions:
- Standard transrectal prostatic biopsy is insufficient for optimal PCDR.
- An extended biopsy method, including sampling from the peripheral zone, significantly improves PCDR, particularly for localized prostate cancer.
- Optimizing the number and location of biopsy sites is critical for accurate prostate cancer diagnosis.