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十或十二針經直腸超音波攝護腺切片與傳統六針切片對攝護腺癌偵測的比較

Comparison of Ten TRUS-Guided and Six Sextant Prostate Biopsy in the Prostate Cancer Detection

摘要


Objectives: After October, 2000, we performed ten transrectal ultrasound (TRUS)-guided prostate biopsy instead of six sextant biopsy to diagnose prostate cancer. We compared the cancer detection and complication rates between the two methods. Methods: A total of 709 patients with elevated Prostate-specific antigen (PSA) and/or abnormal digital rectal examination who received prostate biopsy were retrospectively reviewed. Group l had 324 patients (mean age 68.91 years, range 48 to 95; mean PSA 40.79ng/mL, range 0.26 to 2244). They received six sextant biopsies between January, 1996 and September, 2000. We changed the biopsy method to ten TRUS-guided biopsy in October, 2000. If the prostate volume was larger than 50 cm3, we increased the biopsy number to 12. Group 2 had 385 patients (mean age 68.21 years, range 41 to 89; mean PSA 39.40ng/mL, range 0.21 to 1806.2), they received ten TRUS-guided biopsy between October, 2000 and December, 2002. All Patients were grouped according to serum PSA level(≦4ng/mL,>4 to 10ng/mL,>10 to 20ng/mL,>20 to 50ng/mL,and>50ng/mL).The cancer detection and complication rates were analyzed. Results: Overall prostate cancers were detected in 190/709 (26.80%)patients. Among 324 patients who underwent six sextant biopsy, 81 patients (25.0%) were found to have cancer. The cancer detection rate were 2.56% (PSA≦4ng/mL), 6.29%(PSA>4 to 10ng/mL), 22.67%(PSA>10 to 20ng/mL), 61.76% (PSA>20 to 50ng/mL), 100%(PSA>50ng/mL). Of 385 patients who underwent ten TRUS-guided biopsy, 109 patients (28.31%) were found to have cancer. The cancer detection rate were 10.00% (PSA ≦ 4 ng/ mL), 12.83% (PSA >4 to 10 ng/mL), 29.55% (PSA> 10 to 20 ng/mL), 53.85% (PSA>20 to 50ng/mL), 100% (PSA>50ng/mL). The cancer detection rare was significantly increased by ten TRUS-guided biopsy in the subgroup of patients with PSA>4 to 10ng/mL. (p<0.05) Ten RUS-guided biopsies were well tolerance by all patients without increasing major complication rate. Conclusions: The improvement of cancer detection rate using ten or twelve TRUS-guided biopsy was significant (p<0.05) in patients with PSA level between 4 and 10ng/mL. We advise to perform ten TRUS-guided prostate biopsy instead of six sextant biopsy for suspicious prostate cancer especially with serum PSA level>4 to 10ng/mL.

並列摘要


Objectives: After October, 2000, we performed ten transrectal ultrasound (TRUS)-guided prostate biopsy instead of six sextant biopsy to diagnose prostate cancer. We compared the cancer detection and complication rates between the two methods. Methods: A total of 709 patients with elevated Prostate-specific antigen (PSA) and/or abnormal digital rectal examination who received prostate biopsy were retrospectively reviewed. Group l had 324 patients (mean age 68.91 years, range 48 to 95; mean PSA 40.79ng/mL, range 0.26 to 2244). They received six sextant biopsies between January, 1996 and September, 2000. We changed the biopsy method to ten TRUS-guided biopsy in October, 2000. If the prostate volume was larger than 50 cm3, we increased the biopsy number to 12. Group 2 had 385 patients (mean age 68.21 years, range 41 to 89; mean PSA 39.40ng/mL, range 0.21 to 1806.2), they received ten TRUS-guided biopsy between October, 2000 and December, 2002. All Patients were grouped according to serum PSA level(≦4ng/mL,>4 to 10ng/mL,>10 to 20ng/mL,>20 to 50ng/mL,and>50ng/mL).The cancer detection and complication rates were analyzed. Results: Overall prostate cancers were detected in 190/709 (26.80%)patients. Among 324 patients who underwent six sextant biopsy, 81 patients (25.0%) were found to have cancer. The cancer detection rate were 2.56% (PSA≦4ng/mL), 6.29%(PSA>4 to 10ng/mL), 22.67%(PSA>10 to 20ng/mL), 61.76% (PSA>20 to 50ng/mL), 100%(PSA>50ng/mL). Of 385 patients who underwent ten TRUS-guided biopsy, 109 patients (28.31%) were found to have cancer. The cancer detection rate were 10.00% (PSA ≦ 4 ng/ mL), 12.83% (PSA >4 to 10 ng/mL), 29.55% (PSA> 10 to 20 ng/mL), 53.85% (PSA>20 to 50ng/mL), 100% (PSA>50ng/mL). The cancer detection rare was significantly increased by ten TRUS-guided biopsy in the subgroup of patients with PSA>4 to 10ng/mL. (p<0.05) Ten RUS-guided biopsies were well tolerance by all patients without increasing major complication rate. Conclusions: The improvement of cancer detection rate using ten or twelve TRUS-guided biopsy was significant (p<0.05) in patients with PSA level between 4 and 10ng/mL. We advise to perform ten TRUS-guided prostate biopsy instead of six sextant biopsy for suspicious prostate cancer especially with serum PSA level>4 to 10ng/mL.

被引用紀錄


蔡銘順(2011)。從血清攝護腺特定抗原介於4-10 ng/ml病人中探討有效的攝護腺癌預測因子〔碩士論文,亞洲大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0118-1511201215470978

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