title: Efficiency of 6- and 12-punctures biopsies to detect prostate cancer in patients with PSA </= 10 ng/mL and normal digital rectal examination.
abstract: OBJECTIVE
  Establish the efficiency of 6- and 12-punctures transrectal ultrasound-guided needle biopsies in low risk patients for prostate cancer. Six-punctures (sextant) biopsies were compared to 12-punctures biopsies, assessing which is the best strategy to detect this neoplasm.
  
  
  METHODS
  Among 240 patients submitted to prostate biopsy, 54 with suspected small and organ-localized tumors (prostatic specific antigen </= 10 ng/mL and digital exam of the prostate not suggesting cancer) in glands < 50 cm3 were selected, constituting a homogenous sample. These patients were submitted to standard 3-punctures (basal, mid, and apical) sextant biopsy in parasagittal midline of each prostatic lobe, with 3 additional lateral punctures, bilaterally. Each specimen was separately submitted to histological study.
  
  
  RESULTS
  Twenty-two (40.7%) patients had prostatic cancer, and 28 presented prostatic hyperplasia, associated or not to inflammatory conditions. High-grade prostatic intraepithelial neoplasia (PIN) was detected in 4 patients. From 22 tumors detected by 12-punctures biopsies, 6-punctures biopsies in the parasagittal midline (sextant) diagnosed 50%of the cases, while isolated lateral punctures diagnosed 90.9% of the malignant neoplasms. Basal lateral punctures responded for 72.7% of the cancer diagnosis, while basal sextant punctures responded only for 9.1% of the cases.
  
  
  CONCLUSIONS
  For low risk prostate cancer, patients' 12-punctures biopsy was more effective, for sextant biopsy failed to diagnose half of the cases of neoplasm. Three lateral punctures (basal, mid, and apical), with 2 additional punctures in the parasagittal midline (mid and apical) bilaterally are suggested as the best biopsy strategy.
authors.affiliation: Division of Urology, School of Medicine, Federal University of Paraná, Curitiba, Paraná, Brazil. slongo.uro@mps.com.br
authors.forename: Luiz E
authors.initials: LE
authors.lastname: Slongo
authors.forename: Mário C
authors.initials: MC
authors.lastname: Sugisawa
authors.forename: Sérgio O
authors.initials: SO
authors.lastname: Ioshii
authors.forename: Renato Tâmbara
authors.initials: RT
authors.lastname: Filho
authors.forename: Luiz C A
authors.initials: LC
authors.lastname: Rocha