前立腺系統的16か所生検の臨床的統計

Clinical evaluation of a 16-core systematic prostate biopsy

　前立腺特異抗原（PSA）が3ng/mlを超える，または臨床的に前立腺癌が疑われる152例に系統的前立腺生検を行った。生検は通常の6か所生検のほかに，辺縁域8か所と移行域2か所を加えた計16か所から経直腸的に施行した。癌は68例（45％）で認められたが，6か所生検のみでは15例（22％）で見逃されていた。6か所生検での見逃し症例数は，PSA 10ng/ml以下の群ではそれを超える群より，また，PSA density 0.2以下の群ではそれを超える群よりも有意に多く（p＝0.04およびp＜0.01），16か所生検は特にPSA 10ng/ml以下やPSA density 0.2以下の症例で有用と思われた。

　We performed systematic transrectul prostate biopsy for 152 men with PSA levels over 3ng/ml or with suspected prostate cancer. Biopsy consisted of a conventional systematic 6-core biopsy,together with an additional 8-core peripheral zone and 2-core transition zone biopsy. Our sixteen-core biopsy detected prostate cancer in 68 men（45％）,however,15 cancer patients（22％）would have been overlooked if only a 6-core biopsy had been performed. The number of prostate cancer patients who were undetected by a 6-core biopsy was fewer among those with PSA above 10ng/ml as compared to those with PSA equal or less than 10ng/ml（p＝0.04）,or with PSA density（PSAD）above 0.2 as compared to those with PSAD equal or less than 0.2（p＜0.01）. Thus,it was suggested that the prostate cancer detection rate of a 16-core biopsy was superior to that of a 6-core biopsy,and a 16-core biopsy was useful especially for those with PSA equal or less than 10ng/ml or with PSAD equal or less than 0.2.