Journal of the Formosan Medical Association
Volume 108, Issue 9 , Pages 713-718, September 2009

Diagnostic Value of Finger-guided Prostate Nodule Biopsy Combined With Systemic Random Biopsy

  • I-Ni Chiang

      Affiliations

    • Department of Urology, National Taiwan University Hospital, Taipei Branch, Taiwan
    • College of Medicine, National Taiwan University, Taipei Branch, Taiwan
    • ,
  • Shang-Jen Chang

      Affiliations

    • Department of Urology, Buddhist Tzu Chi General Hospital, Taipei Branch, Taiwan
    • ,
  • Yeong-Shiau Pu

      Affiliations

    • Department of Urology, National Taiwan University Hospital, Taipei Branch, Taiwan
    • College of Medicine, National Taiwan University, Taipei Branch, Taiwan
    • ,
  • Kuo-How Huang

      Affiliations

    • Department of Urology, National Taiwan University Hospital, Taipei Branch, Taiwan
    • College of Medicine, National Taiwan University, Taipei Branch, Taiwan
    • ,
  • Hong-Jen Yu

      Affiliations

    • Department of Urology, National Taiwan University Hospital, Taipei Branch, Taiwan
    • College of Medicine, National Taiwan University, Taipei Branch, Taiwan
    • ,
  • Chao-Yuan Huang

      Affiliations

    • Department of Urology, National Taiwan University Hospital, Taipei Branch, Taiwan
    • College of Medicine, National Taiwan University, Taipei Branch, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Chao-Yuan Huang, Department of Urology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan

Received 4 December 2008; received in revised form 2 March 2009; accepted 29 May 2009.

Background/Purpose

The purpose of this study was to compare prostate cancer detection rates and pathology results, using the Gleason grading system, of 12-core systemic random transrectal ultrasound- guided prostate biopsy (SB) and 3-core finger-guided prostate nodule biopsy (FGNB).

Methods

Between January 2002 and December 2006, 148 patients with digitally palpable prostate nodules received SB and additional FGNB. The prostate cancer detection rates and Gleason scores of positive cancer specimens were compared between SB and combination biopsy (SB + FGNB). The patients' characteristics, including age, prostate specific antigen (PSA), percentage of free PSA and prostate volume were also recorded.

Results

With simple SB, FGNB, and combination biopsy, the prostate cancer detection rates were 39.9%, 37.9%, and 44.6%, respectively. Of the 66 patients with prostate cancer, the Gleason sum was underestimated in three patients with simple SB only and in one patient with FGNB only. The false-negative rates for SB and FGNB were 10.6% and 15.2%, respectively.

Conclusion

In patients with a palpable prostate nodule, combination biopsy with systemic and nodule biopsy could avoid some misdiagnoses of prostate cancer and provide more accurate information for pathology grading.

Key Words:  biopsy , diagnostic techniques and procedures , pathology , prostate cancer

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PII: S0929-6646(09)60394-6

doi:10.1016/S0929-6646(09)60394-6

Journal of the Formosan Medical Association
Volume 108, Issue 9 , Pages 713-718, September 2009

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