Clinical and pathologic tumor characteristics of prostate cancer as a function of the number of biopsy cores: a retrospective study

Naughton, Cathy K.; Smith, Deborah S.; Humphrey, Peter A.; Catàlona, William J.; Keetch, David W.

doi:10.1016/s0090-4295(98)00344-6

Cited by 95 publications

(45 citation statements)

References 12 publications

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“…The optimal protocol regarding the number of cores and their localization is still a matter of debate. 4 When total serum PSA level ranges between 4 and 10 ng/ml, transrectal ultrasound-guided biopsy detects only 22% of cancer at the first biopsy, and repeated second, third and fourth biopsies add 10, 5 and 4% of positive cases, respectively. 5 This is explained, in part, by the lack of detection of cancer on biopsies due to the small number of atypical glands.…”

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confidence: 99%

Identification of PCA3 (DD3) in prostatic carcinoma by in situ hybridization

et al. 2007

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PCA3 is a specific marker of prostatic carcinoma. However, PCA3 has been detected only at RNA level and a corresponding PCA3 protein has never been identified. The aim of this study was to develop a technique capable of detecting PCA3 RNA on histology sections and to assess the cellular location of the molecule. Fortyeight formalin-fixed paraffin-embedded blocks of prostatectomy specimens were selected for PCA3 detection by in situ hybridization by both radioactive and chromogenic methods. Of the 48 sections, 28 contained prostatic adenocarcinoma and 20 had benign tissue located distant from the tumor. Using the radioactive detection method, 26 of 28 available cases (93%) of cancers presented at least focal cytoplasmic PCA3 expression. The benign glands located in proximity of the cancer presented PCA3 expression in eight (29%) cases, whereas those situated distant to the tumor showed focal expression in 2 of 20 (10%) cases only. Highgrade prostatic intraepithelial neoplasia (HGPIN) expressed PCA3 in 25 of 26 (96%) cases. With the chromogenic detection method, 22 of the 24 interpretable cases (92%) of cancers had at least focal cytoplasmic staining. Benign glands located close to neoplastic glands expressed PCA3 in 8 (33%) cases, but none of those distant to the tumor expressed the marker. HGPIN was positive in 17 of 24 (71%) cases. The sensitivity, specificity, positive predictive value and negative predictive value for the detection of cancer were 93, 79, 71 and 95% for the radioactive detective method and 92, 80, 71 and 95% for the chromogenic detection method, respectively. Our study shows that PCA3 RNA is expressed by most prostate cancers and HGPIN. Normal glands rarely express the marker, except those located in immediate proximity of neoplastic glands, suggesting the presence of precursor molecular changes.

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confidence: 99%

Identification of PCA3 (DD3) in prostatic carcinoma by in situ hybridization

et al. 2007

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“…Naughton et al [79] have shown no correlation between the TRUS-determined PV or pathological weight and the number of biopsies needed for PCa.…”

Section: Resultsmentioning

confidence: 99%

Prostate Saturation Biopsy following a First Negative Biopsy: State of the Art

et al. 2012

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Introduction: Saturation prostate biopsy (SPBx) has been initially introduced to improve prostate cancer (PCa) detection rate (DR) in the repeat setting. Nevertheless, the optimal number and the most appropriate location of the cores, together with the timing to perform a second PBx and the eventual modification of the PBx protocols according to the different clinical situations, are matters of debate. The aim of this review is to perform a critical analysis of the literature about the actual role of SPBx in the repeat setting. Materials and Methods: We performed a systematic review of the literature since 1995 up to 2011. Electronic searches were limited to the English language, using the MEDLINE database. The key words ‘saturation prostate biopsy’ and ‘repeated prostate biopsy’ were used. Results: SPBx improves PCa DR if clinical suspicion persists after previous biopsy with negative findings and provides an accurate prediction of prostate tumor volume and grade, even if the issue about the number and locations of the cores is still a matter of debate. Conclusions: At present, SPBx seems to be really necessary in men with persistent suspicion of PCa after negative initial biopsy and probably in patients with a multifocal high-grade prostatic intraepithelial neoplasia or atypical small acinar proliferation. In the remaining situations, adopting an individualized scheme is preferable.

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“…They showed this to be true using a mathematical model that took into account prostate volume. Taking this concept further, Naughton et al 21 Five prospective studies [24][25][26][27][28] have been reported detailing cancer detection rates with increasing numbers of biopsy cores (Table 2). Nava et al 24 reported no increase in the cancer detection rate until 18 cores had been obtained, at which point a detection improvement of 17% was observed.…”

Section: Biopsy Techniquementioning

confidence: 99%