전립선 생검 수에 따른 근치적 전립선적출술 후 Gleason Score의 일치도 비교
Concordance of Gleason Scores between Prostate Needle Biopsy and Radical Prostatectomy Specimens according to the Number of Biopsy Cores
김용준, 장인호, 길명철, 홍성규, 변석수, 이상은,
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김용준 ( Kim Yong-June )
서울대학교 의과대학 비뇨기과학교실
장인호 ( Chang In-Ho )
서울대학교 의과대학 비뇨기과학교실
길명철 ( Gil Myung-Cheol )
서울대학교 의과대학 비뇨기과학교실
홍성규 ( Hong Sung-Kyu )
서울대학교 의과대학 비뇨기과학교실
변석수 ( Byun Seok-Soo )
서울대학교 의과대학 비뇨기과학교실
이상은 ( Lee Sang-Eun )
서울대학교 의과대학 비뇨기과학교실
KMID : 0358320060470050482
Abstract
Purpose: Accurate grading of tumor is critical for administering the correct prostate cancer treatment. Meanwhile, the concordance of Gleason scores (GS) between sextant prostate needle biopsy and the radical prostatectomy (RP) specimen is known to be poor. We investigate if extended needle biopsy could improve the cancer detection rate and GS accuracy.
Materials and Methods: A total 826 consecutive patients each underwent 12 core prostate biopsies guided by TRUS. Of these patients, 136 consecutive patients underwent RP. Of the systemic 12 cores, we compared the subset of standard sextant cores, the set of lateral sextant cores and the 12 core set.
Results: The biopsy were positive in 218 cases(26.4%), 213 cases(25.7%) and 265 cases(32%) for the standard sextant, lateral sextant and twelve core biopsy, respectively. Concordance between prostate biopsy and prostatectomy GS was observed in 71 of 104 cases(68.3%), 80 of 110 cases (72.7%) and 98 of 136 cases(72.1%) for the standard sextant, lateral sextant and twelve core biopsy, respectively. Upgrading of 1 or more points was done in 26 of 104 cases(25.0%), 19 of 110 cases(17.3%) and 26 of 136 cases (19.1%), and downgrading 1 or more point was done in 7 of 104 cases (6.7%), 11 of 110 cases(10.0%) and 12 of 136 cases(8.8%) with the standard sextant, lateral sextant and twelve core biopsy, respectively.
Conclusions: Twelve core needle biopsies lead to a higher cancer detection rate than do the sextant and lateral sextant needle biopsies. Twelve core and lateral sextant needle biopsies lead to higher concordance of the needle biopsy and surgical specimen GS compared with the standard sextant needle biopsy. (Korean J Urol 2006;47:482-488)
키워드
Biopsy;Prostatic neoplasm;Prostatectomy
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