Anterior apical biopsy: is it useful for prostate cancer detection?
OBJECTIVE
To evaluate the utility of a 12-core prostate biopsy protocol including apical anterior peripheral zone (AAPZ) cores.


METHODS
Between February 2002 and October 2006, 10-core and 12-core initial transrectal prostate biopsies were performed on 164 and 549 men, respectively. Two AAPZ-directed biopsies were included in the 12-core biopsy. During the same period, 12-core repeat biopsies including six AAPZ sites were performed on 118 men.


RESULTS
Cancer was found in 66 cases (40.2%) in the 10-core biopsy group and in 252 (45.9%) in the 12-core biopsy group. In this latter group, 13 (5.2%) of the 252 men with positive biopsy had cancer exclusively in the AAPZ cores. When the cancer detection rate at initial biopsy in AAPZ alone was compared according to the digital rectal examination (DRE) findings, it was significantly higher in men with normal rather than abnormal DRE: 12/250 (3.4%) vs 1/185 (0.5%) (P < 0.01). In repeat 12-core biopsies, cancer was detected in 25 (21.2%) men and 9 of them (36.0%) had cancer exclusively in the AAPZ cores. The cancer detection rate from AAPZ sites was significantly higher in repeat biopsy than that in initial biopsy (P < 0.01).


CONCLUSIONS
Addition of the AAPZ site-directed biopsy had greater utility in men with normal DRE and particularly in patients with a prior negative biopsy.
Orikasa
Kazuhiko
K
Department of Urology, Tohoku University, Sendai, Miyagi, Japan. korikasa@bc4.so-net.ne.jp
Ito
Akihiro
A
Ishidoya
Shigeto
S
Saito
Seiichi
S
Endo
Mareyuki
M
Arai
Yoichi
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*