Comparison of systematic and combined biopsy for the detection of prostate cancer  

作　　者：Jin-Lun Huang Da Huang Tsun-Tsun Chun Chi Yao Yong-Le Zhan Xiao-Hao Ruan Terence Chun-Ting Lai Chiu-Fung Tsang Karl-Ho Pang Ada Tsui-Lin Ng Dan-Feng Xu Brian Sze-Ho Ho Rong Na 

机构地区：[1]Department of Urology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China [2]Division of Urology,Department of Surgery,LKS Faculty of Medicine,The University of Hong Kong,Hong Kong,China [3]Division of Urology,Department of Surgery,Queen Mary Hospital,Hong Kong,China

出　　处：《Asian Journal of Andrology》2024年第5期517-521,共5页亚洲男性学杂志（英文版）

基　　金：funded by grants from the National Natural Science Foundation of China(No.81972645);an Innovative research team of high-level local universities in Shanghai,the Shanghai Youth Talent Support Program,an intramural grant of The University of Hong Kong to RN,and from the Shanghai Sailing Program(No.22YF1440500)to DH.

摘　　要：Systematic prostate biopsy has limitations,such as overdiagnosis of clinically insignificant prostate cancer and underdiagnosis of clinically significant prostate cancer.Magnetic resonance imaging(MRI)-guided biopsy,a promising alternative,might improve diagnostic accuracy.To compare the cancer detection rates of systematic biopsy and combined biopsy(systematic biopsy plus MRI-targeted biopsy)in Asian men,we conducted a retrospective cohort study of men who underwent either systematic biopsy or combined biopsy at two medical centers(Queen Mary Hospital and Tung Wah Hospital,Hong Kong,China)from July 2015 to December 2022.Descriptive statistics were calculated,and univariate and multivariate logistic regression analyses were performed.The primary and secondary outcomes were prostate cancer and clinically significant prostate cancer.A total of 1391 participants were enrolled.The overall prostate cancer detection rates did not significantly differ between the two groups(36.3%vs 36.6%,odds ratio[OR]=1.01,95%confidence interval[CI]:0.81-1.26,P=0.92).However,combined biopsy showed a significant advantage in detecting clinically significant prostate cancer(Gleason score≥3+4)in patients with a total serum prostate-specific antigen(tPSA)concentration of 2-10 ng ml−1(systematic vs combined:11.9%vs 17.5%,OR=1.58,95%CI:1.08-2.31,P=0.02).Specifically,in the transperineal biopsy subgroup,combined biopsy significantly outperformed systematic biopsy in the detection of clinically significant prostate cancer(systematic vs combined:12.6%vs 24.0%,OR=2.19,95%CI:1.21-3.97,P=0.01).These findings suggest that in patients with a tPSA concentration of 2-10 ng ml−1,MRI-targeted biopsy may be of greater predictive value than systematic biopsy in the detection of clinically significant prostate cancer.

关 键 词：clinically significant prostate cancer combined biopsy prostate cancer systematic biopsy transperineal biopsy 

分 类 号：R737.25[医药卫生—肿瘤]