Value of perineural invasion in prostate needle biopsy in the assessment on tumor progression / 中华泌尿外科杂志

ABSTRACT

Objective To assess perineural invasion in prostate needle biopsy ( PNIb) on patholog-ical staging , progression of prostate cancer . Methods This retrospective study recruited clinical data of 316 prostate cancer patients with mean age of 69 years from Jan.2006 to Mar.2013.The mean PSA before biopsy was 15.7μg/L.All patients underwent CT or MRI and radionuclide bone scan and had not been found local tumor invasion or distant metastasis .Transrectal ultrasound-guided prostate needle biopsy was performed to all candidates , and the preoperative diagnosis was localized prostate cancer .All patients were treated by laparoscopic radical prostatectomy (LRP).In this study, differences of Gleason score in prostatectomy speci-men, positive surgical margin (PSM), capsular invasion, seminal vesical invasion were analyzed between two groupsgroup Apatients with PNIb;group Bpatients with no PNIb.We also studied the concordance of PNI distribution in PNIb and perineural invasion in prostatectomy specimen ( PNIp). Results The overall rate of PNIb was 32.5%.Difference of Gleason score ≤6 (16 in group A, 92 in group B), Gleason score=7 (46 in group A, 87 in group B), Gleason score ≥8 (41 in group A, 34 in group B) was statisti-cally significant (P<0.05).Of these two groups, differences in PSM (75 in group A, 43 in group B), cap-sular invasion (47 in group A, 36 in group B), and seminal vesical invasion (32 in group A, 23 in group B) were of statistical significant (P<0.05).At the multivariable logistic regression analysis , PNIb was inde-pendent predictor of PSM , capsular invasion, seminal vesicle invasion ( OR=11.358, OR=1.785, OR=2.364, P<0.05).All 22 patients with bilateral PNIb had bilateral PNIp .Of 81 patients with unilateral PNIb,55 had bilateral PNIp .The difference of distribution between PNIb and PNIp was of statistical signifi-cant (P<0.001). Conclusions PNIb is useful for evaluating the progression of prostate cancer .