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

Background/PurposeThe 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).MethodsBetween 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.ResultsWith 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.ConclusionIn 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.