A Retrospective Analys Is Comparing 13 Versus 6 Prostate Biopsy Cores: Impaction On Cancer Detection

Objective: To compare 6 to 13 prostate biopsy cores for determining the impact on the prostate cancer detectionrate. Methods:the biopsies were performed on 120 patients whose digital rectal examination showed a hard mass or nodule,serum prostate specific antigen(PSA) level was higher than 4ng/ml or transrectal ultrasound results showed unusual echo.All patients was between 49 and 87 years old, mean 67.4 years, PSA1.2~105ng/ml, the average 21.3ng/ml,including PSA<4ng/ml for 4cases,4ng/ml15ng/ml for 64 cases.DRE negative in 91 cases, positive in 29 cases.Prostate volume 12.5~186.4ml, an average of 62.5ml.Compare with sextent biopsy,all patient uses transrectual ultrasound prostate biopsy of 13-core at 5 region technology.and then to comparative analysis the difference among puncture number, location, total serum prostate specific antigen (TPSA) level,prostate volume, prostate specific antigen density (PSAD), patient age, digital rectal examination with the assistance of stastics and analysis the positive rate of each puncture location.Results: Among 120 cases with prostate biopsy , 44cases were prostate cancer (PCA) , the positive rate is 36.7%; 64 cases were benign prostatic hyperplasia (BPH) , 53.3%; 12 cases were prostatic intraepithelial lesions (PIN) ,10%. The positive rates of sextent biopsy and 13-core at 5 regionwere biopsy were 30% (36/120) and 36.7% (44/120) respectively,which is meat that the 13-core at 5 regionwere biopsy make the positive rate 18.2%(8/44)(P <0.05)higher.The difference is more clearly in the cases with prostate specific antigen≤15ng/ml, negative DRE, prostate volume>40ml, prostate specific antigen density≤0.20, and age<70 years old patients , the differences were statistically significant (P <0.05).Total puncture stitch are 572 , positive rate is 71.2%, Gleason score 2-10, average 6.8.including Gleason score 2-4 in 4 cases, PSA 8.7ng/ml; Gleason score 5-6 in 22 cases, PSA 15.2ng/ml; Gleason score 7-8 in 10 cases, PSA 26.8ng/ml; Gleason score 9-10 in 8 cases, PSA 46.6ng/ml; 18 cases were the Gleason score>7 and average PSA level>15ng/ml,12 cases of them indicated nerve metastasis.13 by increasing the needle puncture in the peripheral zone may better predict prostate cancer stage. The complications of it are as follows:gross hematuria was 71 cases(59.2%),bloodystool was 30 cases(25%),infection was 6 cases(5%).No blood sperm, prostate abscess, bacteremia and other serious complications. Conclusion: 13-core biopsy than the 6-core aspiration of prostate cancer found a higher positive rate, better predict tumor stage.Choice of biopsy method, should be flexibilitys.