Prostat Kanserinde Biyopsi ve Yöntemleri
Özet
Prostat kanseri (PKa) tanısında histopatolojik inceleme amacıyla yapılan prostat biyopsisi, temel tanı araçlarından biridir. Bu işlemle malign hücrelerin varlığı doğrulanabilir ve hastalığın evresi belirlenebilir. Günümüzde farklı biyopsi yöntemleri kullanılmakta olup, her birinin avantaj ve sınırlılıkları bulunmaktadır. En yaygın kullanılan yöntem, transrektal ultrason (TRUS) eşliğinde yapılan sistematik prostat biyopsisidir. Rektal yoldan yerleştirilen ultrason probu ile prostat görüntülenir ve belirlenen bölgelerden iğneyle doku örnekleri alınır. Bu işlem genellikle lokal anestezi altında gerçekleştirilir. Alternatif olarak, transperineal biyopsi yöntemi uygulanabilir. Bu teknikte, iğne perineal cilt yoluyla prostat bezine ulaşır. Enfeksiyon riski daha düşüktür ve anterior bölgelerdeki lezyonların örneklenmesinde etkilidir. Yeni bir yöntem olan manyetik rezonans-füzyon biyopsi, multiparametrik manyetik rezonans görüntülerin(MpMRG) ultrason ile birleştirilmesiyle şüpheli alanlardan hedefe yönelik örnekleme yapılmasını sağlar. Bu sayede klinik anlamlı kanserlerin saptanma oranı artmaktadır. Biyopsi yöntemi, hastanın klinik durumu, radyolojik bulgular ve hekimin deneyimi göz önünde bulundurularak seçilmelidir.
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