经直肠超声阴性前列腺癌患者的临床病理特征分析

目的 探讨穿刺病理证实为前列腺癌而经直肠超声（TRUS）检查阴性患者的临床病理特征。方法 选择2015年1月至2017年1月TRUS引导下经会阴途径前列腺穿刺后病理诊断为前列腺癌患者73例，根据TRUS图像特征分为TRUS阴性组31例与TRUS阳性组42例，比较两组患者的临床病理特征。结果TRUS阳性组血清PSA水平为（71.27±9.71）ng／ml，高于TRUS阴性组的（41.62±6.43）ng／ml，差异有统计学意义（P<0.05），而两组的年龄、主要区域与次要区域的Gleason评分、微血管计数、癌组织长度占穿刺组织长度比例（最典型一针）、临床分期、无明显自觉症状例数、血管淋巴管侵犯例数、神经侵犯例数及浸润周围组织例数的差异均无统计学意义（P＞0.05）。结论TRUS阴性前列腺癌患者较TRUS阳性患者，除血清PSA水平明显较低外，临床特征、病理特征和侵袭性并无明显区别。对伴血清PSA水平或（和）临床症状异常而TRUS阴性者，仍需积极行前列腺系统穿刺病理检查，以免贻误临床治疗。

Clinical and pathological features analysis of prostate cancer patients with negative transrectal ultrasonography findings

Objective To analyze the clinical and pathological features of prostate cancer patients with negative transrectal ultrasonography （TRUS） findings. Methods Seventy-three prostate cancer patients diagnosed by TRUS-guided transperineal biopsy were enrolled in this study from January 2015 to January 2017. All the patients were divided into negative TRUS group（n=31） and positive TRUS group（n=42） according to TRUS findings. The clinical and pathological features of the two groups were analyzed and compared. Results The serum prostatic spelific antigen（PSA） level of TRUS positive group was （71.27±9.71） ng／ml， higher than （41.62±6.43） ng／ml of TRUS negative group （P<0.05）. However， there were no significant differences in terms of age， Gleason score in primary and secondary areas， microvessel density， length of tumor tissue length （the most typical needle）， clinical staging， number of no obvious symptoms， number of vascular lymphangiosis， number of nerve invasion and number of infiltrating surrounding tissues between two groups （P＞0.05）. Conclusion If the patients with abnormal serum PSA level or （and） clinical symptoms but without suspicious TRUS findings， TRUS-guided prostate sysmatic biopsy is still necessary for them in order to avoid delaying the clinical treatment.