
RESULTADOS DE UNA SERIE DE 6000 PACIENTES CON BIOPSIA TRANSRECTAL ECODIRIGIDA DE PRÓSTATA. PARTE I: ANATOMÍA PATOLÓGICA,TACTO RECTAL, ECOGRAFÍA TRANSRECTAL Y PSA
Rafael Rodríguez-Patrón Rodríguez, Teodoro Mayayo Dehesa, Mónica Alonso González, Francisco Javier Burgos Revilla, Alberto Lennie Zucharino
RESULTADOS DE UNA SERIE DE 6000 PACIENTES CON BIOPSIA TRANSRECTAL ECODIRIGIDA DE PRÓSTATA. PARTE I: ANATOMÍA PATOLÓGICA,TACTO RECTAL, ECOGRAFÍA TRANSRECTAL Y PSA
OBJECTIVES: To analyze the results oftransrectal ultrasound (TRUS) guided biopsy of the prostatein 6000 patients, and their relation to common-useclinical parameters.METHODS: We collected PSA, digital rectal examination,TRUS characteristics, and pathology report in a data base including 6000 patients who underwent sextantTRUS biopsy from 1994 to December 2002. 861 ofthem underwent more than one biopsy, accounting fora total of 7127 biopsies. Sextant biopsy with samplesfrom the most lateral portions of the prostate was thestandard procedure so that they included peripheralzone only. We analyze pathological results and theirrelation with clinical variables.RESULTS: Total percentage of cancer in biopsy sampleswas 42.6%, with 39.1% in the first biopsy. Overall,repeated biopsies resulted in a 3.5% diagnostic yieldincrease. PIN or focal glandular atypia were detectedin 2.0% and 2.1% of the cases respectively. Thepercentage of patients with Gleason score =<6 increasedfrom 41.8% in the first biopsy to 70% in the third.Similarly, single core involvement increased from 21.%to 65%. Digital rectal examination and presence ofhypoechogenic nodules specificity were 82.6 and78.2% respectively. The incidence of prostate cancerwith PSA between 4 and 10 ng/ml was 29.6%,16.7% in those with PSA lower than 4 ng/ml.CONCLUSIONS: TRUS biopsy of the lateral prostaticareas offers a good diagnostic yield in comparison withmost series of extensive biopsies. The sensitivity of TRUShas decreased but it maintains a high specificity whichshould not be forgotten when planning the TRUSstrategy.
Transrectal ultrasound guided prostate biopsy / Prostate cancer / Transrectal ultrasound / Digital rectal examination {{custom_keyword}} /
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