經直腸超音波導引下攝護腺穿刺篩檢18針與12針在肛門指診正常及PSA:4~20ng/mL患者中篩檢前列腺癌的對比性研究
王柏仁、陳正哲、歐宴泉、洪啟峰、楊晨洸、程千里、賀昊中、裘坤元、蘇重光、王賢祥、
陳卷書、李建儀
台中榮民總醫院 外科部 泌尿科
Compare prostate cancer detection rate between 12- and 18-core prostate biopsy in patients with normal dre and serum psa level of 4.0-20.0 ng/ml
Bo-Ren Wang , Cheng Che Chen, Yen-Chuan Ou, Chi-Feng Hung, Cheng-Kuang Yang,
Chen-Li Cheng, Hao-Chung Ho, Kun-Yuan Chiu, Chung-Kuang Su, Shian-Shiang Wang,
Chuan-Shu Chen, Jian-Ri Li
Divisions of Urology, Department of Surgery, Taichung Veterans General Hospital, Taiwan.
Purpose: To compare 12 and 18 core trans-rectal ultrasound (TRUS)-biopsy in patients with normal DRE (digital rectal exam) and PSA level of 4.0-20.0 ng/mL
Materials and Methods: Between 2009 to 2014, 346 patients whose DRE were normal or rubber and serum PSA level between 4.0 and 20.0 ng/mL underwent TRUS biopsy. Of those patients, 318 underwent 12-core biopsy and 28 underwent 18-core biopsy. We compared the prostate cancer detection rates and post-biopsy complications rate between the two groups.
Results: The baseline characteristics of the two groups were comparable with regard to the mean age, prostate volume and PSA level, and PSA density. In the 12-core prostate biopsy group, 36 (11.3%) patients were found to have prostate cancer. On the other hand, in the 18-core prostate biopsy group of patients, 4 (14.2%) were found to have prostate cancer. There were no significant different prostate cancer detection rate between 12-core biopsy and 18-core biopsy group. Besides, in patients with PSA density (PSAD) < 0.2, the prostate cancer detection rate was slightly higher in the 18-core biopsy group(14.3%) than in the 12-core biopsy group(9.6%), but not statistically significant. There was no significant difference complication rates as urinary retention or sepsis between the two groups
Conclusions: We can’t conclude that TRUS-guided 18-core biopsy of the prostate is superior to the 12-core in patients with normal DRE and serum PSA level of 4.0-20.0 ng/mL. Further studies in different population with greater sample size are needed to draw final conclusion.