经会阴前列腺饱和分层穿刺在前列腺特异性抗原灰区患者中诊断前列腺癌的临床研究

目的 探讨直肠超声引导下经会阴前列腺饱和分层穿刺法在前列腺特异性抗原（PSA）灰区患者中诊断前列腺癌的临床应用.方法 2011年1月至2012年8月对58例怀疑前列腺癌的PSA灰区（PSA 4 ～ 10 ng/ml）患者进行直肠超声引导下经会阴前列腺饱和分层穿刺活检.结果 穿刺术后病理确诊前列腺癌16例,穿刺阳性率27.6％,良性前列腺增生24例（41.4％）,低级别上皮内瘤变14例（24.1％）,高级别上皮内瘤变1例（1.7％）,前列腺炎3例（5.2％）；术后主要并发症：血尿14例（24.1％）,急性附睾炎1例（1.7％）,无发热、血便、尿痛等并发症.结论 直肠超声引导下经会阴前列腺饱和分层穿刺法操作简单安全、患者痛苦小、并发症少,可以提高PSA灰区患者前列腺癌的诊断率,值得临床进一步推广.

Clinical analysis of transperineal saturation prostate layered biopsy in diagnosis of prostate cancer in PSA gray zone

Objective To explore the role of transrectal ultrasound-guided transperineal saturation prostate layered biopsy in diagnosis of prostate cancer in PSA gray zone.Methods From Jan.2011 to Aug.2012,58 patients whose PSA lever lied between 4-10 ng/ml received transrectal ultrasound-guided transperineal saturation prostate layered biopsy.Results 16 cases （27.6％） were diagnosed prostate cancer,38 cases （41.4％） were benign prostate hyperplasia,14 cases （24.1％）were high grade intraepithelial neoplasia,one case （1.7％）was high grade i ntraepithelial neoplasia,3 cases （5.2 ％） were prostatitis; main complications after prostate biopsy：14 cases （24.1％） of hematuria,one case （1.7％） of acute epididymitis,without fever,blood stool,dysuria.Conclusions Transrectal ultrasound-guided transperineal saturation prostate layered biopsy which can improve the diagnosis rate of prostate cancer in PSA gray zone patients is simple and safe,patients suffer less and have low complications.It＇s worthy of further clinical promotion.