title: Differences in biopsy features between prostate cancers located in the transition and peripheral zone.
abstract: OBJECTIVE
  To identify the zonal location of prostate cancers before surgery, by analysing the mapping of ultrasonography-guided systematic sextant biopsies for differences between cancers located in the transition zone (TZ) and peripheral zone (PZ); and to compare the correlation between Gleason scores of needle biopsies and those of radical prostatectomy (RP) specimens.
  
  
  METHODS
  In all, 186 patients with TZ (46) and PZ cancers (140) underwent ultrasonography-guided systematic sextant biopsy and RP at the same institution. The clinical and pathological characteristics, and the anatomical location of positive biopsies, were determined and compared using t-tests and chi-square tests. Differences between Gleason scores of needle biopsies and those of RP specimens were evaluated and compared by Cohen kappa testing.
  
  
  RESULTS
  TZ cancers had a significantly lower rate of positive biopsies in the middle (63% vs 80%) and base (50% vs 80%) of the prostate than had PZ cancers. Positive biopsies were exclusively obtained from the apex in 19.6% of TZ and 5% of PZ cancers (P = 0.002). There was exact agreement between Gleason scores of needle biopsies and those of RP specimens in 15.2% of TZ (kappa = 0.02) and 55% of PZ cancers (kappa = 0.25), respectively.
  
  
  CONCLUSIONS
  Compared with PZ cancers, TZ cancers had a different anatomical pattern of positive biopsies, with lower rates in the middle and base of the prostate. The finding of positive biopsies exclusively in the apex favoured prostate cancer located in the TZ. Furthermore, the correlation between needle biopsy Gleason scores and those of the RP specimens was clearly lower in TZ cancers.
authors.affiliation: Department of Urology, University Hospital Hamburg-Eppendorf, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Augustin
authors.forename: A
authors.initials: A
authors.lastname: Erbersdobler
authors.forename: M
authors.initials: M
authors.lastname: Graefen
authors.forename: T
authors.initials: T
authors.lastname: Jaekel
authors.forename: A
authors.initials: A
authors.lastname: Haese
authors.forename: H
authors.initials: H
authors.lastname: Huland
authors.forename: P G
authors.initials: PG
authors.lastname: Hammerer
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology*
chemical_list: D017430:Prostate-Specific Antigen