Transrectal aspiration biopsy of the prostate. A re-evaluation of the method in the diagnosis of prostatic carcinoma.

Cytologic results with transrectal aspiration biopsy of the prostate were analyzed after 20 years of experience, in order to re-evaluate the accuracy of the method in the diagnosis of prostatic carcinoma. Carcinoma was cytologically diagnosed with increasing frequency with increased age of the patient and increased grade of clinical suspicion. For instance carcinoma was diagnosed in only 10% of cases under 50 years of age and in more than 50% of cases over 80. At first biopsy carcinoma was diagnosed in only one out of 175 patients without clinical suspicion of malignancy and in 98% of the cases with strong suspicion of malignancy at rectal palpation. By repeating aspiration biopsy in clinically suspected cases the danger of false negative report is minimized. A good correlation was found between cytologic findings and histologic control in 350 patients. Prostatic carcinoma was detected cytologically in about 96% of the cases. A false positive diagnosis is not to be feared when the diagnostic work is performed by a trained staff.