Author/Editor		Brnić, Zoran; Anić, Petar; Gašparov, Slavko; Radović, Nikola; Kučan, Damir; Vidas, Željko; Lozo, Petar; Ramljak, Vesna
Title		Is quadrant biopsy adequate as first-line sampling scheme in men likely to have non-organ-confined prostate cancer: comparison to extended biopsy protocol
Translated title		Primerjava kvadrantne in razširjene biopsije prostate kot prvo vzorčenje pri bolnikih z napredovalo obliko raka prostate
Type		članek
Source		Radiol Oncol
Vol. and No.		Letnik 39, št. 1
Publication year		2005
Volume		str. 37-47
Language		eng
Abstract		Background. While extensive prostate biopsy (PB) in the patients with early prostate cancer (PC) provides better sensitivity and more precise tumour staging, in the patients with advanced PC, it is virtually only a confirmation of malignancy. The purpose of our study was to find out whether the quadrant prostate biopsy (QPB) provides a sufficient first-line pathological evaluation in the patients likely to have advanced PC, and whether the reduction of core number impairs the competence of PB through missing quantitative histology information. Methods. We studied 84 men who underwent PB and classified into groups »Ha (highly ) and »L« (low likely to have advanced PC). Pathological results of 5-12 cores PB and simulated QPB were retrospectively compared, particularly for the presence of PC, tumour volume, Gleason score (GS), and the presence of htghgrade prostatic intraepithelial neoplasia (HGPIN). Results. The PC detection rate was not impaired in group H, but dropped significantly in group L, while the percentage of positive cores was insignificantly changed in group H (p=0.39), but significantly decreased in group L (p=0.04) due to the sampling scheme reduction. No HGPIN was missed with QBP in group H, while 2 HGPIN were missed in group L. Insignificant GS changes resulted in both groups as a consequence of the limitation to QPB. Conclusions. QPB is an appropriate first-line scheme in the patients with advanced PC as the information lost due to the core number reduction is mainly not critical for patient management.
Summary		Izhodišča. Pri bolnikih z zgodnjim rakom prostate omogoča razširjena biopsija prostate (BP) boljšo senzitivnost in natančnejšo zamejitev tumorja, pri bolnikih z razširjenim rakom prostate pa je potrebna samo potrditev raka z BP. Z raziskavo smo želeli ugotoviti, ali je kvadrantna BP primerna za patološko oceno pri bolnikih, ki imajo verjetno napredovali rak prostate. Prav tako smo želeli ugotoviti, ali zmanjšanje števila vzorcev poslabša zanesljivost BP zaradi manjkajočih kvantitativnih histoloških podatkov. Bolniki in metode. Pregledali smo podatke 84 moških, pri katerih je bila opravljena BP in so bili razdeljeni v skupini "H" (verjeten) in "L" (malo verjeten) napredovali rak prostate. Patohistološke izvide 5-12 vzorcev BP in simuliranih kvadrantnih BP smo retrospektivno primerjali med seboj, posebej glede na prisotnost raka prostate, volumen tumorja, Gleasonovo točkovanje in prisotnost prostatične intraepitelne neoplazme visokega gradusa (HGPIN). Rezultati. V skupini H je bila stopnja detekcije raka prostate primerljiva, signifikantno pa je padla v skupini L pri simuliranih kvadrantnih BP. Tako se je število pozitivnih vzorcev v skupini H samo neznačilno spremenilo (p = 0,39) in se je značilno zmanjšalo v skupini L (p = 0,04) zaradi zmanjšanja vzorčenja. Prav tako v skupini H nismo spregledali nobene HGPIN, medtem ko smo v kupini L spregledali dve. Kot posledica zmanjšanja števila vzorcev se je Gleasonovo točkovanje v obeh skupinah neznačilno spremenilo. Zaključki. Pri bolnikih z napredovalim rakom prostate je kvadrantna BP primeren prvi diagnostični postopek, saj z njo dobimo dovolj pomembnih podatkov. Zmanjšanje števila vzorcev praviloma ne vpliva na odločitev o vrsti zdravljenja napredovalega raka prostate.
Descriptors		PROSTATIC NEOPLASMS PROSTATE-SPECIFIC ANTIGEN BIOPSY, NEEDLE