Needle biopsies on autopsy prostates

Sensitivity of cancer detection based on true prevalence

Gabriel P. Haas, Nicolas Barry Delongchamps, Richard F. Jones, Vishal Chandan, Angel M. Serio, Andrew J. Vickers, Mary Jumbelic, Gregory Threatte, Rus Korets, Hans Lilja, Gustavo De La Roza

Research output: Contribution to journalArticle

154 Citations (Scopus)

Abstract

Background It is difficult to estimate the diagnostic accuracy of biopsy for prostate cancer because men with negative biopsy do not undergo radical prostatectomy and thus have no confirmation of biopsy findings. Methods We performed 18-core needle biopsies on autopsy prostates from 164 men who had no history of prostate cancer. Six-core biopsies were taken from each of the mid peripheral zone (MPZ), the lateral peripheral zone (LPZ), and the central zone (CZ). We tested associations between age and tumor characteristics and analyzed the sensitivity of biopsies at each site. All statistical tests were two-sided. Results Prostate cancer was present in 47 (29%) prostates. Of the 47 cancers detected, 20 were clinically significant according to histologic criteria. Tumor volume was associated with tumor grade (P =.012) and with age (P<.001). The biopsies from the CZ did not detect any cancer that was not present in biopsies of either the MPZ or LPZ. The sensitivity of the biopsies taken from the MPZ and LPZ together (53%, 95% confidence interval [CI] = 38% to 68%) was therefore the same as that of 18-core biopsies and was superior to that of biopsies of the MPZ alone (30%, 95% CI = 17% to 45%) (P =.003). The sensitivities of biopsies from the MPZ for clinically significant and insignificant cancer were 55% (95% CI = 32% to 77%) and 11% (95% CI = 2% to 29%), respectively, compared with 80% (95% CI = 56% to 94%) and 33% (95% CI = 17% to 54%) for those from the MPZ and LPZ combined. Conclusions The ability to detect prostate cancer was more related to the biopsy site than to the number of biopsy cores taken. The 12-core biopsies, six cores each from the MPZ and LPZ, were most likely to detect the majority of clinically significant cancers but also detected many insignificant cancers. When the six-core biopsies from the CZ were added, no increase in sensitivity was observed.

Original languageEnglish (US)
Pages (from-to)1484-1489
Number of pages6
JournalJournal of the National Cancer Institute
Volume99
Issue number19
DOIs
StatePublished - Oct 2007
Externally publishedYes

Fingerprint

Needle Biopsy
Autopsy
Prostatic Neoplasms
Biopsy
Confidence Intervals
Neoplasms
Prostate
Large-Core Needle Biopsy
Prostatectomy
Tumor Burden

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Haas, G. P., Delongchamps, N. B., Jones, R. F., Chandan, V., Serio, A. M., Vickers, A. J., ... De La Roza, G. (2007). Needle biopsies on autopsy prostates: Sensitivity of cancer detection based on true prevalence. Journal of the National Cancer Institute, 99(19), 1484-1489. https://doi.org/10.1093/jnci/djm153

Needle biopsies on autopsy prostates : Sensitivity of cancer detection based on true prevalence. / Haas, Gabriel P.; Delongchamps, Nicolas Barry; Jones, Richard F.; Chandan, Vishal; Serio, Angel M.; Vickers, Andrew J.; Jumbelic, Mary; Threatte, Gregory; Korets, Rus; Lilja, Hans; De La Roza, Gustavo.

In: Journal of the National Cancer Institute, Vol. 99, No. 19, 10.2007, p. 1484-1489.

Research output: Contribution to journalArticle

Haas, GP, Delongchamps, NB, Jones, RF, Chandan, V, Serio, AM, Vickers, AJ, Jumbelic, M, Threatte, G, Korets, R, Lilja, H & De La Roza, G 2007, 'Needle biopsies on autopsy prostates: Sensitivity of cancer detection based on true prevalence', Journal of the National Cancer Institute, vol. 99, no. 19, pp. 1484-1489. https://doi.org/10.1093/jnci/djm153
Haas, Gabriel P. ; Delongchamps, Nicolas Barry ; Jones, Richard F. ; Chandan, Vishal ; Serio, Angel M. ; Vickers, Andrew J. ; Jumbelic, Mary ; Threatte, Gregory ; Korets, Rus ; Lilja, Hans ; De La Roza, Gustavo. / Needle biopsies on autopsy prostates : Sensitivity of cancer detection based on true prevalence. In: Journal of the National Cancer Institute. 2007 ; Vol. 99, No. 19. pp. 1484-1489.
@article{7bc4409b545b4a05b55fbd1530c759f3,
title = "Needle biopsies on autopsy prostates: Sensitivity of cancer detection based on true prevalence",
abstract = "Background It is difficult to estimate the diagnostic accuracy of biopsy for prostate cancer because men with negative biopsy do not undergo radical prostatectomy and thus have no confirmation of biopsy findings. Methods We performed 18-core needle biopsies on autopsy prostates from 164 men who had no history of prostate cancer. Six-core biopsies were taken from each of the mid peripheral zone (MPZ), the lateral peripheral zone (LPZ), and the central zone (CZ). We tested associations between age and tumor characteristics and analyzed the sensitivity of biopsies at each site. All statistical tests were two-sided. Results Prostate cancer was present in 47 (29{\%}) prostates. Of the 47 cancers detected, 20 were clinically significant according to histologic criteria. Tumor volume was associated with tumor grade (P =.012) and with age (P<.001). The biopsies from the CZ did not detect any cancer that was not present in biopsies of either the MPZ or LPZ. The sensitivity of the biopsies taken from the MPZ and LPZ together (53{\%}, 95{\%} confidence interval [CI] = 38{\%} to 68{\%}) was therefore the same as that of 18-core biopsies and was superior to that of biopsies of the MPZ alone (30{\%}, 95{\%} CI = 17{\%} to 45{\%}) (P =.003). The sensitivities of biopsies from the MPZ for clinically significant and insignificant cancer were 55{\%} (95{\%} CI = 32{\%} to 77{\%}) and 11{\%} (95{\%} CI = 2{\%} to 29{\%}), respectively, compared with 80{\%} (95{\%} CI = 56{\%} to 94{\%}) and 33{\%} (95{\%} CI = 17{\%} to 54{\%}) for those from the MPZ and LPZ combined. Conclusions The ability to detect prostate cancer was more related to the biopsy site than to the number of biopsy cores taken. The 12-core biopsies, six cores each from the MPZ and LPZ, were most likely to detect the majority of clinically significant cancers but also detected many insignificant cancers. When the six-core biopsies from the CZ were added, no increase in sensitivity was observed.",
author = "Haas, {Gabriel P.} and Delongchamps, {Nicolas Barry} and Jones, {Richard F.} and Vishal Chandan and Serio, {Angel M.} and Vickers, {Andrew J.} and Mary Jumbelic and Gregory Threatte and Rus Korets and Hans Lilja and {De La Roza}, Gustavo",
year = "2007",
month = "10",
doi = "10.1093/jnci/djm153",
language = "English (US)",
volume = "99",
pages = "1484--1489",
journal = "Journal of the National Cancer Institute",
issn = "0027-8874",
publisher = "Oxford University Press",
number = "19",

}

TY - JOUR

T1 - Needle biopsies on autopsy prostates

T2 - Sensitivity of cancer detection based on true prevalence

AU - Haas, Gabriel P.

AU - Delongchamps, Nicolas Barry

AU - Jones, Richard F.

AU - Chandan, Vishal

AU - Serio, Angel M.

AU - Vickers, Andrew J.

AU - Jumbelic, Mary

AU - Threatte, Gregory

AU - Korets, Rus

AU - Lilja, Hans

AU - De La Roza, Gustavo

PY - 2007/10

Y1 - 2007/10

N2 - Background It is difficult to estimate the diagnostic accuracy of biopsy for prostate cancer because men with negative biopsy do not undergo radical prostatectomy and thus have no confirmation of biopsy findings. Methods We performed 18-core needle biopsies on autopsy prostates from 164 men who had no history of prostate cancer. Six-core biopsies were taken from each of the mid peripheral zone (MPZ), the lateral peripheral zone (LPZ), and the central zone (CZ). We tested associations between age and tumor characteristics and analyzed the sensitivity of biopsies at each site. All statistical tests were two-sided. Results Prostate cancer was present in 47 (29%) prostates. Of the 47 cancers detected, 20 were clinically significant according to histologic criteria. Tumor volume was associated with tumor grade (P =.012) and with age (P<.001). The biopsies from the CZ did not detect any cancer that was not present in biopsies of either the MPZ or LPZ. The sensitivity of the biopsies taken from the MPZ and LPZ together (53%, 95% confidence interval [CI] = 38% to 68%) was therefore the same as that of 18-core biopsies and was superior to that of biopsies of the MPZ alone (30%, 95% CI = 17% to 45%) (P =.003). The sensitivities of biopsies from the MPZ for clinically significant and insignificant cancer were 55% (95% CI = 32% to 77%) and 11% (95% CI = 2% to 29%), respectively, compared with 80% (95% CI = 56% to 94%) and 33% (95% CI = 17% to 54%) for those from the MPZ and LPZ combined. Conclusions The ability to detect prostate cancer was more related to the biopsy site than to the number of biopsy cores taken. The 12-core biopsies, six cores each from the MPZ and LPZ, were most likely to detect the majority of clinically significant cancers but also detected many insignificant cancers. When the six-core biopsies from the CZ were added, no increase in sensitivity was observed.

AB - Background It is difficult to estimate the diagnostic accuracy of biopsy for prostate cancer because men with negative biopsy do not undergo radical prostatectomy and thus have no confirmation of biopsy findings. Methods We performed 18-core needle biopsies on autopsy prostates from 164 men who had no history of prostate cancer. Six-core biopsies were taken from each of the mid peripheral zone (MPZ), the lateral peripheral zone (LPZ), and the central zone (CZ). We tested associations between age and tumor characteristics and analyzed the sensitivity of biopsies at each site. All statistical tests were two-sided. Results Prostate cancer was present in 47 (29%) prostates. Of the 47 cancers detected, 20 were clinically significant according to histologic criteria. Tumor volume was associated with tumor grade (P =.012) and with age (P<.001). The biopsies from the CZ did not detect any cancer that was not present in biopsies of either the MPZ or LPZ. The sensitivity of the biopsies taken from the MPZ and LPZ together (53%, 95% confidence interval [CI] = 38% to 68%) was therefore the same as that of 18-core biopsies and was superior to that of biopsies of the MPZ alone (30%, 95% CI = 17% to 45%) (P =.003). The sensitivities of biopsies from the MPZ for clinically significant and insignificant cancer were 55% (95% CI = 32% to 77%) and 11% (95% CI = 2% to 29%), respectively, compared with 80% (95% CI = 56% to 94%) and 33% (95% CI = 17% to 54%) for those from the MPZ and LPZ combined. Conclusions The ability to detect prostate cancer was more related to the biopsy site than to the number of biopsy cores taken. The 12-core biopsies, six cores each from the MPZ and LPZ, were most likely to detect the majority of clinically significant cancers but also detected many insignificant cancers. When the six-core biopsies from the CZ were added, no increase in sensitivity was observed.

UR - http://www.scopus.com/inward/record.url?scp=35148846265&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=35148846265&partnerID=8YFLogxK

U2 - 10.1093/jnci/djm153

DO - 10.1093/jnci/djm153

M3 - Article

VL - 99

SP - 1484

EP - 1489

JO - Journal of the National Cancer Institute

JF - Journal of the National Cancer Institute

SN - 0027-8874

IS - 19

ER -