The implication of initial 24-core transrectal prostate biopsy protocol on the detection of significant @entity263 and high grade XXXX .

@entity1 @entity263 @entity5436
PURPOSE: To assess the diagnostic value of an initial 24-sample transrectal ultrasound guided (TRUS) prostate biopsy protocol compared to the 10-core technique. MATERIALS AND METHODS: We retrospectively reviewed the prostate biopsy database of consecutive @entity1 undergoing prostate biopsies under local anesthesia by using the 10 (Group A) and 24 (Group B) protocols. @entity1 were stratified according to biopsy protocol and PSA levels. Exclusion criteria were age >=  75 years and PSA > 20 ng/mL. The Mann-Whitney U and Fisher's exact test were used for statistical analysis. RESULTS: Between April 2007 and August 2009, 869 @entity1 underwent TRUS prostate biopsies of which 379 were eligible for the study. Group A (10-cores) consisted of 243 (64.11%) @entity1 and group B (24-cores) included 139 (35.89%) @entity1 . The @entity263 detection rate was 39.09% and 34.55% in Group A and B, respectively (p = 0.43). An overall 9.8% increase in Gleason 7 detection rate was found in Group B (p = 0.24). The high-grade @entity5436 (HGPIN) detection rate in @entity1 with negative initial biopsies was 15.54% and 35.55% in Group A and B, respectively (p < 0.001). In @entity1 with PSA < 10 ng/mL, the 24-core technique increased Gleason 7 detection rate by 13.4% (p = 0.16) and HGPIN by 23.4% (p = 0.0008), compared to the 10 core technique. The 24-core technique increased the concordance between needle biopsy and prostatectomy specimen compared to 10-core technique (p < 0.002). CONCLUSIONS: The initial 24-core prostate biopsy protocol did not show any benefit in the detection of @entity263 compared to the 10-core technique. However, it improved the HGPIN detection and the correlation between biopsy results and radical prostatectomy Gleason score in @entity1 with lower PSA levels.
