Transrectal versus transperineal prostate biopsy for cancer detection in patients with gray-zone prostatespecific antigen:a multicenter,real-world study  

作　　者：Jun-Xiao Liu Ze-Yuan Wang Shao-Xi Niu Xiao-Yong Sai Xu Zhang Xue-Pei Zhang Xin Ma 

机构地区：[1]The Graduate School,Chinese PLA General Hospital,Beijing 100853,China [2]Department of Urology,The Third Medical Center,Chinese PLA General Hospital,Beijing 100853,China [3]Department of Urology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China [4]Department of Urology,The First Medical Center,Chinese PLA General Hospital,Beijing 100853,China [5]Faculty of Epidemiology and Statistics,The Graduate School,Chinese PLA General Hospital,Beijing 100853,China.

出　　处：《Asian Journal of Andrology》2024年第4期377-381,共5页亚洲男性学杂志（英文版）

摘　　要：Knowledge about the effect of different prostate biopsy approaches on the prostate cancer detection rate(CDR)in patients with gray-zone prostate-specific antigen(PSA)is limited.We performed this study to compare the CDR among patients who underwent different biopsy approaches and had rising PSA levels in the gray zone.Two hundred and twenty-two patients who underwent transrectal prostate biopsy(TRB)and 216 patients who underwent transperineal prostate biopsy(TPB)between June 2016 and September 2022 were reviewed in this study.In addition,110 patients who received additional targeted biopsies following the systematic TPB were identified.Clinical parameters,including age,PSA derivative,prostate volume(PV),and needle core count,were recorded.The data were fitted via propensity score matching(PSM),adjusting for potential confounders.TPB outperformed TRB in terms of the CDR(49.6%vs 28.3%,P=0.001).The clinically significant prostate cancer(csPCa)detection rate was not significantly different between TPB and TRB(78.6%vs 68.8%,P=0.306).In stratified analysis,TPB outperformed TRB in CDR when the age of patients was 65–75 years(59.0%vs 22.0%,P<0.001),when PV was 25.00–50.00 ml(63.2%vs 28.3%,P<0.001),and when needle core count was no more than 12(58.5%vs 31.5%,P=0.005).The CDR(P=0.712)and detection rate of csPCa(P=0.993)did not significantly differ among the systematic,targeted,and combined biopsies.TPB outperformed TRB in CDR for patients with gray-zone PSA.Moreover,performing target biopsy after systematic TPB provided no additional benefits in CDR.

关 键 词：BIOPSY detection of cancer prostate-specific antigen TRANSPERINEAL TRANSRECTAL 

分 类 号：R737.25[医药卫生—肿瘤]