Huseyin KOCAN, Ilker YİLDİRİM, Sinharib CİTGEZ, Mahmut TOKTAS, Selahattin ÇALIŞKAN, Enver ÖZDEMİR

Perifere yönlendirilmiş 12 odak prostat biyopsi uygulamasında prostat dışı ve yetersiz doku örneklemesine etki eden faktörler

Amaç: Prostat kanseri prostat dokusunun periferine daha fazla yerleşim gösterdiğinden, doku örneklemelerinde prostatın laterallerine yönlendirilmesi önerilmektedir. Lateral örneklemelerde bazı odaklarda prostat dışı doku ve prostatın anatomisinden dolayı yetersiz doku ile karşılaşılmaktadır. Transrektal ultrasonografi (TRUS) eşliğinde alınan sistematik prostat biyopsilerinde prostat dışı doku saptanmasına etki eden faktörler araştırıldı.Gereç ve Yöntemler: Retrospektif olarak TRUS eşliğinde 12 odak sistematik prostat biyopsisi alınan 2509 hastanın, patoloji spesmenlerinde prostat dışı doku saptanan (grup 1) ve tüm odakların prostat dokusu olanlar (grup 2) olarak iki gruba ayrıldı. Ayrıca; yaş, prostat volümleri (PV), prostat spesifik antijen (PSA) ,dijital rektal muayene (DRM) (şüpheli olanlar ve normal olanlar) faktörlerinin prostat dışı doku gelmesinin etkileri araştırıldı.Bulgular: 2509 hastanın 467(%18.61)’sinde prostat dışı doku saptandı, ortalama yaşı 65,6 yıl, ortalama PSA 14 ng/ml, ortalama PV 45.5, %19.7’sinin dijital rektal muayenesi şüpheli, %25,8 sinde prostat kanseri saptandı. Gruplar arasında yaş (p=0.220), PSA (p=0.030), prostat volüm (0.065), dijital rektal muayene (DRM) (p=0.09) ve patoloji sonucunun (p=0.052) prostat dışı doku saptanmasına etkileri istatistiksel anlamlılık değerleri elde edildi.Sonuç: Sistematik 12 odak TRUS eşliğinde alınan prostat biyopsisinde, prostat dışı doku olmayanlarda PSA değerleri daha yüksektir. Tümör (+) tespit edilen hastaların tümör negatiflere göre prostat dışı doku olmama oranları gözlemsel olarak daha yüksektir. DRM şüpheli olan hastaların prostat dışı doku olmama oranları gözlemsel olarak daha yüksek saptandı.

Anahtar Kelimeler:

Prostat, Trans-rektal biyopsi, Prostat dışı doku, Transrektal Ultrasonografi

The factors affecting the examination of outside of prostate and its incomplete tissues sampling in 12 core guided prostatic biopsies directed to the periphery

Objectives: During prostate tissue sampling, it is recommended to direct toward the lateral of the prostate as prostate cancer displays more localization toward the periphery of prostate tissue. Insufficient tissue sampling is frequently encountered in lateral biopsies, due to the outside structure of the prostate and the prostatic anatomy. We aimed to determine the factors affecting this failure in systematic prostate biopsies taken accompanied by transrectal ultrasonography (TRUS).Material and Methods: A total of 2509 patients who underwent systematic 12-core guided TRUS biopsy of the periphery in our clinic were enrolled in the study and scanned retrospectively. Patients were divided into two groups as those with non-prostate tissue identified in pathology specimens (Group 1) and with only prostate tissue in all foci (Group 2). Each of the patients were evaluated for age, prostate volume, prostate-specific antigen (PSA), number of tissue samples taken from the periphery in 12-core guided biopsy, normal or abnormal digital rectal examination (DRE) results, absence or presence of tumor in the pathology.Results: Of the 2509 patients, 467 (18.61%) were identified to have non-prostate tissue. Mean age was 65.6 years, mean PSA was 14 ng/mL, mean PV was 45.5, 19.7% had suspect digital rectal examination and 25.8% were positive for tumor. Among the groups, statistically significant values were obtained for the effects of age (p=0.220), PSA(p=0.030), prostate volume (0.065), digital rectal examination (DRE) (p=0.09) and identification of non-prostate tissue in pathology result (p=0.052).Conclusion: The PSA values of those without non-prostate tissue in prostate biopsy taken with systematic 12-core TRUS were higher. Patients with tumor identified (+) were observed to have higher observational rates of no non-prostate tissue compared to patients negative for tumor. Patients with suspect DRE were identified to have higher observational rates of no non-prostate tissue.

Keywords:

Biopsy, Transrectal biopsy, Non-prostate tissue, Transrectal Ultrasonography,

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