혈청 PSA가 증가된 환자에서 생검부위 및 생검수에 따른 전립선암 진단율 비교
Comparative Analysis of the Prostate Cancer Detection Rate according to Region and Number of Biopsy in Patient with Elevated Serum PSA
안흥석, 권칠훈, 주관중,
소속 상세정보
안흥석 ( Ahn Heung-Seok )
성균관대학교 의과대학 비뇨기과학교실
권칠훈 ( Kwon Chil-Hoon )
성균관대학교 의과대학 비뇨기과학교실
주관중 ( Joo Kwan-Joong )
성균관대학교 의과대학 비뇨기과학교실
KMID : 0358320060470060591
Abstract
Purpose: We evaluated the rate of prostate cancer detection according to the region and number of biopsies in patients with an elevated level of serum prostate-specific antigen(PSA).
Materials and Methods: Transrectal ultrasound(TRUS) guided prostate biopsies were performed at 12 regions, using the standard sextant, with an additional 6 cores from the far lateral peripheral zone, in 178 men with an elevated PSA level, and with no suspicious lesions of prostate cancer on digital rectal examination(DRE) and TRUS. We analyzed the rate prostate cancer detection according to the region, number of biopsies, the PSA level, prostate volume and PSA density (PSAD).
Results: The rates of cancer detection were 12.9, 11.8 and 7.4% in the 12 core, lateral 6 core and medial 6 core (standard sextant) biopsies, respectively(p＜0.05). There were no differences in overall cancer detection rates between 12 core and lateral 6 core plus apex medial 2 core biopsies(12.9%). In men with a PSA level greater than 20ng/ml, no difference in cancer detection was found with the 12 core or either of the 6 core biopsies(positive rate 33.3%). In men with a PSA level over 10ng/ml, a prostate volume less than 49cc or a PSAD greater than 0.15, a lateral 6 core biopsy made no difference to the diagnosis of prostate cancer compared to a 12 core biopsy.
Conclusions: A lateral 6 core biopsy, combined with an apex medial 2 core biopsy, is a more efficient method for the detection of prostate cancer than the standard sextant biopsy in men with an elevated serum PSA level without a suspicious lesion on DRE and TRUS. (Korean J Urol 2006;47: 591-595)
키워드
Prostatic neoplasms;Biopsy;Prostate-specific antigen
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