Transperineal Parallel Biopsy of the Prostate: A New Approach of Tissue Sampling for Precision Medicine

Min Qu; Bijun Lian; Yan Wang; Wenhui Zhang; Feng Zhu; Tao Wang; Xiaodong Yue; Zepeng Jia; Huan Chen; Husheng Li; Jing Li; Xu Gao

doi:10.2147/IJGM.S302105

Transperineal Parallel Biopsy of the Prostate: A New Approach of Tissue Sampling for Precision Medicine

Int J Gen Med. 2021 May 3:14:1631-1640. doi: 10.2147/IJGM.S302105. eCollection 2021.

Authors

Min Qu^#¹, Bijun Lian^#^{1

2}, Yan Wang^#¹, Wenhui Zhang¹, Feng Zhu^{1

3}, Tao Wang⁴, Xiaodong Yue⁵, Zepeng Jia¹, Huan Chen¹, Husheng Li¹, Jing Li^{1

6}, Xu Gao¹

Affiliations

¹ Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China.
² Department of Urology, The 903th PLA Hospital, Hangzhou, People's Republic of China.
³ Department of Urology, Tianyou Hospital, Tongji University, Shanghai, People's Republic of China.
⁴ Department of Urology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.
⁵ Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai, People's Republic of China.
⁶ Center for Translational Medicine, Second Military Medical University, Shanghai, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Through an observational study to present a new approach for obtaining high-quality samples for the targeted therapy of prostate cancer.

Patients and methods: Parallel biopsy, which was defined as collecting the tissue from the same site by two biopsies, was performed on patients with elevated PSA. Each tissue was stained by ink to identify the pathological characteristics, including Gleason score and tumor tissue ratio. Kendall tau-b test and intraclass correlation coefficient test were used to compare the consistency between each paired sample. Then, based on the pathology of the biopsies, high-quality tissues would be selected for sequencing, and PyClone model was used to track the clonal evolution.

Results: In total, 252 pairs of biopsies were collected. The consistency of Gleason score between each paired biopsy is 0.777 (p<0.01), and the consistency of tumor tissue ratio is 0.853 (p<0.01). With the application of parallel biopsy, on average five nonsynonymous mutations could be identified in patients with castration-resistant prostate cancer. Six out of eight had at least one biology-relevant alteration in patients, guiding further treatment. Meanwhile, clonal evolution was constructed to investigate the progress of tumor.

Conclusion: Parallel biopsy is a reliable approach to collect high-quality tissue and shows potential application in precision medicine.

Keywords: clonal evolutionary tree; next-generation sequencing; precision medicine; prostate biopsy; prostate cancer.

Grants and funding

This study is supported by National Natural Science Foundation of China (81602467, Jing Li); Sub-project under “Zhangjiang National Innovation Demonstration Zone” Initiative Development Fund (2017JZ17, Xu Gao); Shanghai Sailing Program (19YF1447000, Min Qu).