8点及12点前列腺穿刺活检诊断前列腺癌的价值比较研究

目的比较8点及12点前列腺穿刺活检诊断前列腺癌的价值,分析前列腺特异性抗原(PSA)、前列腺特异性抗原密度(PSAD)及前列腺体积(PV)对前列腺癌检出率(PCDR)的影响。方法回顾性分析260例因PSA异常增高而接受首次直肠超声引导下前列腺穿刺活检的患者相关资料,其中132例患者接受8点穿刺,128例患者接受12点穿刺。结果依据PSA、PV、PSA与PV及PSAD,患者被进一步分组。8点及12点的总的PCDR没有显著的差异,在PV≥45mL、PSA≥10ng/mL且PV≥45mL及0.15ng/(mL·cm3)≤PSAD≤0.25ng/(mL·cm3)组中,12点的PCDR明显高于8点。结论 8点及12点前列腺穿刺总的PCDR没有显著区别(P0.05),但在PV较大同时PSA较高或者PSAD处于中等大小时(0.15~0.25)ng/(mL·cm3),12点的PCDR明显高于8点(P均0.05)。

A comparative analysis of 8-and 12-core prostate biopsy in the detection of prostate cancer

Objective To retrospectively compare the to evaluate the impact of prostate specific antigen （PSA）, diagnostic significance of 8-core and 12-core prostate biopsies and PSA density （PSAD） and prostate volume （PV） on the prostate cancer detection rate （PCDR）. Methods A total of 260 patients with total PSA〉/4.0 ng/mL undergoing first-time transrectal ultrasound-guided biopsy were included. Patients in Group Ⅰ （n = 132） underwent 8-core biopsy and group Ⅱ （n = 128） 12- core biopsy. Results The patients were further stratified into subgroups according to PSA （cut-off： 10.0 ng/mL）, PV （cut- off：45 mL）,PSA level and PV simultaneously and PSAD（cut-off： 0.15, 0.25）. The PCDR did not differ significantly in group Ⅰ （34. 1% ） and group Ⅱ （42.9% ）. 12-Core biopsy yielded a significantly higher PCDR than 8-core biopsies in patients with PV≥45 mL, PSA≥10 ng/mL and PV≥45 mL, 0.15 ng/（mL·cm3 ）≤PSAD≤0, 25 ng/（mL·cm3）. Conclusion There are no statistically significant differences with PCDR in all patients between 8 and 12-core prostate biopsy protocols （P〉0.05）, but 12-core biopsy yielded a significantly higher PCDR in patients with a higher PSA and larger PV,with intermediate PSAD level.