Repetición de la biopsia prostática ecodirigida para la detección de cáncer. estudio de una serie de 192 pacientes re-biopsiados

Abstract

PurposeWe reviewed the result of transrectal ultrasound (TRUS)-guided needle biopsies to find the rebiopsy criteria, emphasizing on the Focal Glandular Atypia (FGA) histological changes. Material And Method192 cases were selected, from a total of 1957 patients older than 50, re-biopsied because of high PSA levels and/or abnormal DRE, or because of the histological findings on initial biopsies (high grade PIN and/or FGA). The results are related to the serum PSA levels and DRE characteristics. ResultsA 38.83% global positivity for cancer was obtained and 27.08% for re-biopsy. When the first biopsy was negative, the positivity of the re-biopsies was 19.37%; if it was negative for cancer but had high grade PIN and/or FGA changes, the positivity was 65.62%, being higher in FGA changes than in the PIN cases (68.00% vs. 57.14%). The abnormal DRE raised the positivity rate from 17.82% to, 35.75%. ConclusionsThe positivity was especially related to abnormal DRE and/or PSA ??10 ng/ml. The tumor rate detected at second and third or successive biopsies was similar (19.28% vs 21.74%). The FGA changes (3.47% globally) had a cancer predictive value of 65,62%. We recommend re-biopsy in all patients with FGA changes.