ABSTRACT
Introducción. La biopsia prostática transrectal ecoguiada (BxP) es la técnica más utilizada para el diagnóstico de cáncer. El objetivo de este estudio fue analizar los factores asociados a la de detección de cáncer en la primera BxP en nuestro centro. Métodos. Se incluyeron BxP primarias entre 2008 y 2014. La indicación para BxP se clasificó como: (I) APE normal y velocidad elevada, (II) APE normal con tacto rectal sospechoso, (III) valor único de APE elevado, (IV) APE repetido elevado y (V) APE ≥10 ng/ml. Resultados Serie de 917 pacientes. Un 41 por ciento de las BxP incluyeron 12 a 19 muestras y un 44 por ciento 20 a 22. La tasa de detección global fue 43 por ciento. Se encontraron diferencias significativas al relacionar la tasa de detección con el valor del APE, tacto rectal sospechoso, edad, densidad de APE y volumen prostático. La tasa de detección en el grupo de 12 a 19 muestras fue 34 por ciento y un 41 por ciento con 20 a 22 muestras (p=0,092). Se reportaron 7 complicaciones mayores. Conclusiones. La tasa de detección en esta serie es alta al compararla con lo publicado. Los factores asociados a mayor detección son similares a lo descrito habitualmente. El templado con más muestras se asocia a una tendencia más alta en la tasa de detección, aunque no significativa, sin encontrar mayor proporción de cáncer de bajo riesgo y con una frecuencia de complicaciones comparable con lo reportado. (AU)
Introduction. Transrectal ultrasound guided prostate biopsy is the most widely used method for the diagnosis of prostate cancer. The goal of this study was to analyse the variables associated with the detection of cancer in the first biopsy. Primary biopsies of our centre dating between 2008 and 2014 were included. Biopsy indications were classified as: (I) Normal PSA with elevated growth rate, (II) Normal PSA with suspicious digital rectal examination, (III) Isolated elevation of PSA, (IV) Persistent elevation of PSA and (V) PSA ≥10 ng/ml. Results. Among 917 patients, 41pertcent of biopsies included between 12 and 19 samples, 44 percent ranged from 20 to 22 samples. Global detection rate was 43 pertcent. Significant differences were found when correlating detection rate with PSA value, suspicious digital rectal examination, patient age, PSA density and prostate volume. Detection rate in the 12 to 19 samples group was 34 pertcent and 41 pertcent in the 20 to 22 samples group (p=0,092). 7 mayor complications were reported. Conclusion. In this series the detection rate is higher than the reported in published literature. Variables associated with a higher detection rate were similar as those reported by literature. A higher number of samples template is associated with a higher detection rate, nevertheless the differences were not statistically significant, it did not have a higher low risk cancer detection rate and had an incidence of complications similar to the previously reported. known risk factors of upgrading are a high level of PSA and the prostate volumen. Interesting is that we encounter asociation between of CAPRA score => 2 and upgrading, this is other element to consider in the evaluation of the patient prior to treatment. (AU)