경직장 초음파 유도 41부위 전립선 생검법 = A Protocol for Transrectal, Ultrasonography-guided, 41-core Prostate Needle Biopsy

다국어 초록 (Multilingual Abstract)

Purpose: We evaluated the rate of prostate cancer detection using the transrectal ultrasound(TRUS) guided, 41-core prostate needle biopsy protocol.
Materials and Methods: Between May 2006 and May 2007, 110 patients received a 12-core prostate needle biopsy(Group I) and 62 patients underwent a 41-core prostate needle biopsy(Group II) under local anesthesia. In addition to sextant biopsy, 41-core prostate needle biopsies were obtained from the each lateral peripheral zone(base, mid, and apex glands), midline peripheral zone(base, mid, and apex glands) and each transition zone.
Results: There were no significant differences between the two groups for age, prostate-specific antigen(PSA), or prostate volume. The cancer detection rate in the Group I and Group II was 19.1% and 24.2%, respectively. We found a significantly higher detection rate in the 41-core biopsy with prostate volumes of more than 40cc(28.1% vs 11.3%). The intraoperative pain score was lower in Group II than Group I(1.57±1.45 vs 3.17±1.73, p＜0.01).
Conclusions: The 41-core prostate needle biopsy protocol is safe and intraoperative pain is low. The cancer detection rate of the 41-core prostate needle biopsy was higher than the 12-core prostate needle biopsy in patients with a prostate volume of more than 40cc. (Korean J Urol 2008; 49:122-126)

다국어 초록 (Multilingual Abstract)

Purpose: We evaluated the rate of prostate cancer detection using the transrectal ultrasound(TRUS) guided, 41-core prostate needle biopsy protocol.
Materials and Methods: Between May 2006 and May 2007, 110 patients received a 12-core prostate needle biopsy(Group I) and 62 patients underwent a 41-core prostate needle biopsy(Group II) under local anesthesia. In addition to sextant biopsy, 41-core prostate needle biopsies were obtained from the each lateral peripheral zone(base, mid, and apex glands), midline peripheral zone(base, mid, and apex glands) and each transition zone.
Results: There were no significant differences between the two groups for age, prostate-specific antigen(PSA), or prostate volume. The cancer detection rate in the Group I and Group II was 19.1% and 24.2%, respectively. We found a significantly higher detection rate in the 41-core biopsy with prostate volumes of more than 40cc(28.1% vs 11.3%). The intraoperative pain score was lower in Group II than Group I(1.57±1.45 vs 3.17±1.73, p＜0.01).
Conclusions: The 41-core prostate needle biopsy protocol is safe and intraoperative pain is low. The cancer detection rate of the 41-core prostate needle biopsy was higher than the 12-core prostate needle biopsy in patients with a prostate volume of more than 40cc. (Korean J Urol 2008; 49:122-126)

참고문헌 (Reference)

1 박용설, "전립선 용적이 통상적인 6등분침생검에 있어서 암검출률에 미치는 영향" 대한비뇨기과학회 44 (44): 1098-1102, 2003

2 여병구, "말초대 10부위 전립선 생검: 과연 효과적인가?" 대한비뇨기과학회 44 (44): 851-854, 2003

3 이영익, "경직장초음파유도 전립선생검 시 국소마취제의 직장내주입과 전립선주위주사요법의 효과 비교" 대한비뇨기과학회 45 (45): 423-427, 2004

4 Epstein JI, "Use of repeat sextant and transition zone biopsies for assessing extent of prostate cancer" 158 : 1886-1890, 1997

5 Levine MA, "Two consecutive sets of transrectal ultrasound guided sextant biopsies of the prostate for the detection of prostate cancer" 159 : 471-475, 1998

6 Nash PA, "Transrectal ultrasound guided prostatic nerve blockade eases systematic needle biopsy of the prostate" 155 : 607-609, 1996

7 Desgrandchamps F, "The rectal administration of lidocaine gel and tolerance of transrectal ultrasonography-guided biopsy of the prostate: a prospective randomized placebo-controlled study" 83 : 1007-1009, 1999

8 Presti JC Jr, "The optimal systematic prostate biopsy scheme should include 8 rather than 6 biopsies: results of a prospective clinical trial" 163 : 163-166, 2000

9 Uzzo RG, "The influence of prostate size on cancer detection" 46 : 831-836, 1995

10 Hammerer P, "Systematic sextant biopsies in 651 patients referred for prostate evaluation" 151 : 99-102, 1994

11 Eskew LA, "Systematic 5 region prostate biopsy is superior to sextant method for diagnosing carcinoma of the prostate" 157 : 199-202, 1997

12 Ashley RA, "Reassessing the diagnostic yield of saturation biopsy of the prostate"

13 Hodge KK, "Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate" 142 : 71-74, 1989

14 Eskew LA, "Prostate cancer diagnosed by the 5 region biopsy method is significant disease" 160 : 794-796, 1998

15 de la Taille A, "Prospective evaluation of a 21-sample needle biopsy procedure designed to improve the prostate cancer detection rate" 61 : 1181-1186, 2003

16 Naughton CK, "Pain and morbidity of transrectal ultrasound guided prostate biopsy: a prospective randomized trial of 6 versus 12 cores" 163 : 168-171, 2000

17 Chen ME, "Optimization of prostate biopsy strategy using computer based analysis" 158 : 2168-2175, 997

18 Hollabaugh RS Jr, "Neuroanatomy of the male rhabdosphincter" 49 : 426-434, 1997

19 Enlund AL, "Morbidity of ultrasound-guided transrectal core biopsy of the prostate without prophylactic antibiotic therapy. A prospective study in 415 cases" 79 : 777-780, 1997

20 Byun SS, "Effect of periprostatic nerve blockade for transrectal ultrasound guided biopsy of the prostate" 45 : 663-666, 2004

21 Rietbergen JB, "Complications of transrectal ultrasound-guided systematic sextant biopsies of the prostate: evaluation of complication rates and risk factors within a population-based screening program" 49 : 875-880, 1997

22 Stroumbakis N, "Clinical significance of repeat sextant biopsies in prostate cancer patients" 49(suppl 3A) : 113-118, 1997

23 Issa MM, "A randomized prospective trial of intrarectal lidocaine for pain control during transrectal prostate biopsy: the Emory University experience" 164 : 397-399, 2000

24 Babaian RJ, "A comparative analysis of sextant and an extended 11- core multisite directed biopsy strategy" 163 : 152-157, 2000

25 조승훈, "6군데 더하기 선택적 유도 전립선 생검법의 유용성" 대한비뇨기과학회 46 (46): 700-703, 2005