经直肠超声及其穿刺活检对前列腺增生与前列腺癌的鉴别诊断价值

目的 评价经直肠超声检查及其穿刺活检对鉴别前列腺增生症与前列腺癌的价值。方法 将40例前列腺疾病患者术后病理分组，与术前经直肠超声检查声像图以及13例穿刺活检结果对照分析。结果 术后前列腺增生组27例，前列腺增生伴炎症组4例，前列腺癌组9例，术前经直肠超声检查诊断前列腺增生27例，疑诊前列腺癌13例并行穿刺活检，其中6例术前穿刺确诊为前列腺癌，3例前列腺癌未穿刺，但术后病理证实，经直肠前列腺癌超声诊断敏感性66．7％，特异性77．4％，准确性75％；而本组穿刺活检对前列腺癌选择性检出率为46．2％，其准确性、敏感性、特异性均为100％。结论 经直肠二维及彩色多普勒超声检查对于鉴别良性前列腺增生症与前列腺癌有着重要价值，可以选择性提高穿刺活检中前列腺癌的检出率，而结合经直肠超声检查的前列腺穿刺活检术则是发现并确诊前列腺癌的有效方法。

The Value of Transrectal Ultrasound and Biopsy in Differentiation Between Benign Prostatic Hyperplasia and Prostate Cancer

Objective To evaluate the value of transrectal ultrasound(TRUS) and biopsy in differentiation between benign prostatic hyperplasia (BPH) and prostate cancer(PC). Methods The value of TRUS was analyzed in 40 cases of prostate diseases confirmed by operation and pathology,including 13 cases confirmed by transrectal biopsy. Results Among these 40 cases, 27 cases were BPH, 4 cases were BPH with chronic inflammation, 9 cases were PC Confirmed by operation and pathology respectively. According to TRUS, 27 cases were BPH, 13 patients suspected to be PC underwent TRUS guided biopsy, 6 cases were PC, 7 cases were BPH. 3 patients who suffered from PC were missed. TRUS's sensitivity, specificity and accuracy for diagnosis of PC were 66.7%, 77.4% and 75% respectively; TRUS guided biopsy's sensitivity, specificity and accuracy for diagnosis of PC were all 100%, its selective detection rate was 46.2%. Conclusion Transrectal ultrasound(TRUS) has very important value in differentiating PC from BPH, it can significantly increase the sensetivity of prostatic cancer. TRUS combined with prostate biopsy guided by TRUS was an effective way of detecting and diagnosing PC.