Objective: To explore whether distinct prostate cancer (PCa) prognoses between ethnicities could be explained by diverse characteristics in the prostate biopsy.

Methods: Clinical, prostate biopsy and surgical single-institution data of whites and African descendants with similar access to the health system who underwent radical prostatectomy whole gland histopathology within 60 days after biopsy from 2010 to 2011 and followed for 5 years minimum were compared.

Results: Among 203 included patients, 153 (75.4%) were whites and 50 (24.6%) were African descendants. The mean patients’ age was 63.7 (± 6.8) years. Digital rectal examination (DRE) was suspected of cancer in 45.2% of the patients. The prostate biopsy core length was smaller in African descendants than in whites, overall 11.0 ± 3.2 vs 12.0 ± 2.9 mm, p = 0.037, and without neoplasia, 10.4 ± 3.8 vs 11.7 ± 3.1 mm, p = 0.038, respectively. Also, suspicious DRE showed smaller biopsy core length, overall 11.1 ± 3.2 mm vs 12.4 ± 2.6, p = 0.003, cancer positive 12.0 ± 4.8 mm vs 13.3 ± 3.7, p = 0.022 and negative 10.6 ± 3.6 mm vs 12.2 ± 3.0, p = 0.002. On 81 months median follow-up, more African descendants were lost to follow-up (10%, n = 5 vs 3.9%, n = 6) and the biochemical recurrence rate was the same between the groups (33.3%).

Conclusion: In a PCa population with similar access to the health system, prostate biopsy core length in African descendant men is significantly smaller than in whites. This finding is new and may add to the controversial argument of PCa having a worse prognosis in African descendant patients.

目的：探讨种族间不同的前列腺癌（PCa）预后是否可以通过前列腺活检的多种特征来解释。

方法：比较2010年至2011年活检后60天内接受根治性前列腺切除术全腺组织病理学且至少随访5年的白人和非洲人后裔进入卫生系统的临床，前列腺穿刺活检和外科手术单机构数据。

结果：在203名患者中，白人为153名（75.4％），非洲裔为50名（24.6％）。患者平均年龄为63.7（±6.8）岁。45.2％的患者怀疑直肠指检（DRE）为癌症。非洲人后裔的前列腺活检核心长度比白人小，总体为11.0±3.2 vs 12.0±2.9 mm，p  = 0.037，无瘤形成，分别为10.4±3.8 vs 11.7±3.1 mm，p  = 0.038。此外，可疑DRE的活检芯长度更小，总体11.1±3.2 mm比12.4±2.6，p  = 0.003，癌阳性12.0±4.8 mm比13.3±3.7，p  = 0.022，阴性10.6±3.6 mm比12.2±3.0，p = 0.002。在81个月的中位随访中，更多的非洲后裔失去了随访（10％，n  = 5对3.9％，n  = 6），两组之间的生化复发率相同（33.3％）。

结论：在具有类似卫生系统访问权限的PCa人群中，非洲后裔男性的前列腺穿刺活检核心长度显着小于白人。这一发现是新发现，可能会增加有争议的观点，即PCa在非洲后代患者中预后较差。