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A novel biopsy scheme for prostate cancer: targeted and regional systematic biopsy.
He, Yang; Fan, Yu; Song, Haitian; Shen, Qi; Ruan, Mingjian; Chen, Yuke; Li, Derun; Li, Xueying; Liu, Yi; Zhang, Kai; Zhang, Qian.
Afiliação
  • He Y; Department of Urology, The Institute of Urology, Peking University First Hospital, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China.
  • Fan Y; Institution of Urology, PekingUniversity, Beijing, 100034, China.
  • Song H; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China.
  • Shen Q; National Urological Cancer Center, Beijing, 100034, China.
  • Ruan M; Department of Urology, The Institute of Urology, Peking University First Hospital, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China.
  • Chen Y; Institution of Urology, PekingUniversity, Beijing, 100034, China.
  • Li D; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China.
  • Li X; National Urological Cancer Center, Beijing, 100034, China.
  • Liu Y; Department of Urology, The Institute of Urology, Peking University First Hospital, Peking University, The National Urological Cancer Center of China, No. 8 Xishiku St., Xicheng District, Beijing, 100034, China.
  • Zhang K; Institution of Urology, PekingUniversity, Beijing, 100034, China.
  • Zhang Q; Beijing Key Laboratory of Urogenital Diseases (Male) Molecular Diagnosis and Treatment Center, Beijing, 100034, China.
BMC Urol ; 24(1): 85, 2024 Apr 13.
Article em En | MEDLINE | ID: mdl-38614971
ABSTRACT

PURPOSE:

To explore a novel biopsy scheme for prostate cancer (PCa), and test the detection rate and pathological agreement of standard systematic (SB) + targeted (TB) biopsy and novel biopsy scheme.

METHODS:

Positive needles were collected from 194 patients who underwent SB + TB (STB) followed by radical prostatectomy (RP). Our novel biopsy scheme, targeted and regional systematic biopsy (TrSB) was defined as TB + regional SB (4 SB-needles closest to the TB-needles). The McNemar test was utilized to compare the detection rate performance for clinical significant PCa (csPCa) and clinical insignificant PCa (ciPCa). Moreover, the accuracy, positive predictive value (PPV) and negative predictive value (NPV) were investigated. The agreement between the different biopsy schemes grade group (GG) and RP GG were assessed. The concordance between the biopsy and the RP GG was evaluated using weighted κ coefficient analyses.

RESULTS:

In this study, the overall detection rate for csPCa was 83.5% (162 of 194) when SB and TB were combined. TrSB showed better NPV than TB (97.0% vs. 74.4%). Comparing to STB, the TB-detection rate of csPCa had a significant difference (p < 0.01), while TrSB showed no significant difference (p > 0.999). For ciPCa, the overall detection rate was 16.5% (32 of 194). TrSB showed better PPV (96.6% vs. 83.3%) and NPV (97.6% vs. 92.9%) than TB. Comparing to STB, the detection rate of both schemes showed no significant difference (p = 0.077 and p = 0.375). All three schemes GG showed poor agreement with RP GG (TB 43.3%, TrSB 46.4%, STB 45.9%). Using weighted κ, all three schemes showed no difference (TB 0.48, TrSB 0.51, STB 0.51). In our subgroup analysis (PI-RADS = 4/5, n = 154), all three schemes almost showed no difference (Weighted κ TB-0.50, TrSB-0.51, STB-0.50).

CONCLUSION:

Our novel biopsy scheme TrSB (TB + 4 closest SB needles) may reduce 8 cores of biopsy compared with STB (standard SB + TB), which also showed better csPCa detection rate than TB only, but the same as STB. The pathological agreement between three different biopsy schemes (TB/TrSB/STB) GG and RP GG showed no difference.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata Limite: Humans / Male Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata Limite: Humans / Male Idioma: En Ano de publicação: 2024 Tipo de documento: Article