Prostat Dokusundaki Kanserin Tespitinde Kanser Lokalizasyonunun Önemi ve Dağılımı
GİRİŞ ve AMAÇ: Bu çalışma ile prostat kanserinin prostat dokusunda dağılımını incelemek ve prostat biyopsisi ile hangi lokalizasyondaki kanserlerin daha yüksek oranda tespit edildiğini değerlendirmeyi amaçladık. YÖNTEM ve GEREÇLER: Hastanemizde radikal prostatektomi yapılan 49 hastanın radikal prostatektomi ve prostat biyopsi spesmenleri retrospektif ve prospektif olarak incelendi. Radikal prostatektomi spesmenleri posteriordan horizontal planda biyopsi alınan bölgelere göre 12 kadrana ayrılırken; sagittal planda ön ve arka olmak üzere 2 bölüme ayrılarak haritalama işlemi yapıldı. Bu alanlarda prostat kanserinin prostat dokusu içindeki dağılımı incelendi. Ayrıca prostat anterior kısmındaki tümörlerin posteriordaki tümörlerle ilişkisi ve saptanmasında prostat ön-arka çapının etkinliği araştırıldı. BULGULAR: Hastanemizde radikal prostatektomi yapılan 49 hastanın radikal prostatektomi ve prostat biyopsi spesmenleri retrospektif ve prospektif olarak incelendi. Radikal prostatektomi spesmenleri posteriordan horizontal planda biyopsi alınan bölgelere göre 12 kadrana ayrılırken; sagittal planda ön ve arka olmak üzere 2 bölüme ayrılarak haritalama işlemi yapıldı. Bu alanlarda prostat kanserinin prostat dokusu içindeki dağılımı incelendi. Ayrıca prostat anterior kısmındaki tümörlerin posteriordaki tümörlerle ilişkisi ve saptanmasında prostat ön-arka çapının etkinliği araştırıldı. TARTIŞMA ve SONUÇ: Prostat biyopsilerinin parmakla alındığı dönemlerde apeksteki tümörlerin yakalanma oranının düşük olduğu bilgisi, görüntüleme eşliğinde yapılan biyopsilerle geçerliliğini yitirmiştir. Özellikle sol bazal-lateral bölgedeki tümörlerde sensitivite en düşük görülmüştür. Prostat anterior bölgesindeki tümör oranları düşük olmakla birlikte sol bazalde tümör saptanması durumunda anteriorda da tümör olması arasında kuvvetli bir ilişki saptanmıştır.
The İmportance of Cancer Location on The Detection of Cancer in Prostate Tissue and Cancer Distribution in Prostate
INTRODUCTION: We aimed to determine the distribution of cancer in prostate and to determin in which localization the cancer is detected with high success by prostate biopsy. METHODS: After having obtained approval of Institutional Ethics Committee, the specimens of radical prostatectomy and prostate biopsy of 49 patients with prostatic adenocarcinoma were evaluated. The radical prostatectomy specimens were maped by dividing in to 12 areas on horizontal plane; and dividing 2 areas as anterior and posterior on sagittal plane. Then the distribution of the cancer in prostate tissue was investigated. The association between anterior and posterior localization was also investigated. RESULTS: Posterior side of right middle lateral area was the most common area with cancer (46.9%), and anterior side of right apex lateral area was the less common area with cancer (20.4%). The sensitivity of prostate biopsy to detect cancer was the highest in left middle lateral area (73%), and was the least in left basal lateral area (47%). Prtostate cancer is mostly localizated in posterior area as presented in our study, and if the cancer occurs in left bazal area, the possibility of tumor occurence in anterior side of this area incrased 50 times. DISCUSSION AND CONCLUSION: In finger guided biyopsies, cancers in the apex were more easy to be missed. But this has expired after imaging methods. The sensitivity of prostate biopsy to detect cancer was the least in left basal lateral area. And there was a strong association of tumor togetherness in anterior and posterior side of left bazal area.
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