系統的前立腺生検におけるTransition zone biopsyの意義

概要

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前立腺癌が疑われた83例について,Peripheral zone 6ヶ所にtransition zone(TZ)2ヶ所を加えた系統的生検を行ったところ,25例に癌が検出された.25例のうちTZのみから癌が検出されたのは1例のみであり,全ての例においてTZ biopsyを行う意義は少ないと考えられたWe evaluated the systematic biopsies performed on 83 patients suspected of having prostate cancer. In the systematic biopsy, 6 cores were from the peripheral zone and 2 cores from the transition zone. Cancer was detected in 25 patients (30.1%). The percentage of patients who had abnormal digital rectal examination and transrectal echo findings, average PSA and PSA density, and the number of examinations which suggested cancer were higher in the cancer group than in the non-cancer group, although the mean prostate volume was smaller. Cancer was more frequently detected in the peripheral zone than in the transition zone. Cancer was detected only in the transition zone in only 1 of the 25 cancer patients. We conclude that biopsy of the transition zone to all the patients is not always needed in systematic biopsy.