改良式经直肠前列腺8点穿刺术在前列腺癌诊断中的应用

目的回顾改良式经直肠前列腺8点穿刺术（常规底部＋中部＋外侧中部＋尖部＋超声可疑点）在临床前列腺癌诊断中的价值,探讨最优化的前列腺穿刺活检方案。方法对2007年12月至2010年1月在我院就医的高度怀疑前列腺癌的96例患者行改良式经直肠前列腺8点穿刺活检术,术后行病理检查。统计前列腺癌的阳性率及各穿刺点癌细胞的阳性率。结果 96例患者中,有37例病理诊断为前列腺癌,占38.54%,21例诊断为前列腺上皮内瘤变（prostatic intraepithelial neoplasm,PIN）,9例为前列腺增生（benign prostatic hyperplasia,BPH）伴慢性炎症,29例为BPH。超声可疑点对前列腺癌判断的敏感度为40.68%。穿刺阳性点多集中在中部、中外侧部或尖部。结论对于初次活检的患者选择改良式前列腺8点穿刺方案是较为合理的。

Role of modified 8-core prostate biopsy protocol in diagnose of prostatic carcinoma

Objective Review the contribution of improved 8-core prostate biopsy protocol that combines cores at the base,mid gland,apex,lateral mid and suspecable point in ultrasound in the prostatic carcinoma detection.To investigate the best prostate biopsy stategy.Methods 96 patients who were highly suspected as the prostatic carcinoma during Dec 2007-Jan 2010 were involved in the study.TURS guided the improved 8-core prostate biopsy protocol was conducted in each patient.The prostatic carcinoma detection rate for each biopsy core was calculated.Results The prostatic carcinoma were detected in 37 of 96 patients.Prostatic intraepithelial neoplasm were detected in 21 patients.Benign prostatic hyperplasia with chronic inflammation were detected in 9 patients.The last 29 patients were diagnosed as benign prostatic hyperplasia.The positive rate of the special core which was named as suspecable point in ultrasound was 40.68%.The cores at the apex,mid gland,lateral mid and base yielded a high percentage of prostatic carcinoma.Conclusions The improved 8-core prostate biopsy protocol that combines cores at the base,mid gland,apex,lateral mid and suspecable point in ultrasound shoud be the reasonable strategy in early detection of prostatic carcinoma.