Authors (including presenting author) :
Wong CK (1)
Affiliation :
(1)Department of Clinical Pathology, Tuen Mun Hospital
Introduction :
Prostate cancer diagnostics depend on the histopathological examination of prostate biopsy. The quality of prostate biopsy affects the results of laboratory examination which in turn determines the successfulness of patient management. Literature review of specimen collection protocols showed that there was a change in the initial six-core biopsies to a traditional ten to twelve transrectal cores biopsies. A recent standard protocol further suggested the collection of more biopsy cores for enhancing the prostate diagnostics in the laboratory. The results of this study provide important insights on the correct choice of procedures in obtaining the best quality of prostate biopsy for laboratory examination.
Objectives :
(1) To compare the transperineal with transrectal prostate biopsy collection protocols. (2) To investigate the recent advances in prostate cancer diagnostics for optimizing the quality of laboratory results reporting and providing better patient management.
Methodology :
An inductive qualitative study was performed which involved the literature review of websites based documents and case study reflective notes, etc. Conclusions were then made based on the findings and patterns identified in the study. The method of ‘maximum variation sample’ was used such that the factor of demographic variable affecting the result of study was eliminated.
Result & Outcome :
Results showed that using the traditional transrectal prostate biopsy suffers from the disadvantage of under-sample prostate. Areas such as the apex and cental zone in large prostate and the anterior prostate cannot be sampled easily. There is also a high sepsis risk for transrectal prostate biopsy and danger of harboring fluoroquinolone-resistant and extended-spectrum beta-lactamase producing rectal flora. The transperineal prostate biopsy, being an alternative of transrectal prostate biopsy, has the advantages of better access to all areas of prostate such as the anterior cores, midgland cores, base cores and posterior cores; and lower sepsis risk than transrectal prostate biopsy. Adopting the transperineal prostate biopsy can achieve a better patient management through improving the cancer detection rate. Extra manpower and resources are required in recent protocol using transperineal prostate biopsy. It involves more biopsy cores with addition duties of specimen preparation, staining, quality control and clerical procedures. It can optimize the quality of laboratory results reporting and providing better patient management through improvements in prostate cancer diagnostics.
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