直肠超声引导下前列腺活检对前列腺癌患者PSA、PSAD的影响

目的探讨直肠超声引导下前列腺活检诊断前列腺癌的效果，并与同期人选的非前列腺癌组织作对照，进一步探讨二者对前列腺特异性抗原（PSA）、PSAD（PSA密度）的影响。方法将前列腺特异性抗原（PSA）水平在2．5ng/mL以上并经直肠超声引导10孔法前列腺活组织检查的70例患者根据检查结果随机分为前列腺癌组44例及非前列腺癌组26例，应用统计学方法比较分析两组的PSA、DRE（直肠指诊）、TRUS（经直肠超声）、PSAD（PSA密度）及前列腺大小、超声表现、活检并发症情况、各项检查的敏感性。结果70例中44例证实患有前列腺癌，26例非癌病例；前列腺癌组与非前列腺癌组在PSA、异常DRE表现比率及异常TRUS表现比率、前列腺大小、PSAD均有统计学差异（P〈0．05）。前列腺癌组织的超声表现与非前列腺癌组织比较，差异有显著性（P〈0．05）。前列腺癌组与非前列腺癌组上述并发症的发生率比较，差异无显著性（P〉0．05）。前列腺癌组的DRE及TRUS的敏感性均明显高于非前列腺癌组，两组比较差异有显著性（P〈0．05）。但前列腺癌组的DRE与TRUS的敏感性对比，差异不显著（P〉0．05），而非前列腺癌组的DRE与TRUS的敏感性对比差异也不显著（P〉0．05）。结论经直肠超声引导下活检穿刺联合应用血清PSA、肛门指诊及经直肠超声检查及PSAD检测，可以更有效指导经直肠超声引导下活检穿刺，具有很高的临床应用价值，能提高诊断率。

The Influence of Transrectal Ultrasound Guided Prostate Biopsy for PSA,PSAD

Objective To investigate the effect of }prostate biopsy prostate cancer under rectal ultrasound-guided,and compared with non-prostate cancer tissue that were selected at the same time. To further explore both of them made the impacts on the prostate spe- cific antigen （PSA）,PSAD （PSA density）. Methods Selected 70 cases which PSA levels were all above 2.Sng/mL and the cases had been treated with transrectal ultrasound-guided 10-hole. According to test results,the eases~ were randomly divided into two groups, prostate cancer group had 44 cases,and non-prostate cancer group had 26 cases.Used statistical methods to compare PSA,DRE,TRUS, PSAD and prostate size,ultrasonography, biopsy complications,each inspection＇s sensitivity of the two groups. Results All of 44 cases had been confirmed to have prostate cancer,26 cases had non-cancer eases. There had significant differences between the two groups about PSA,abnormal DRE performance ratio, and abnormal TRUS performance ratio, prostate size and PSAD（P〈0.05）.The ultrasound showed the difference was significant between prostate cancer and non-prostate cancer tissue （P〈0.05）. There had no significant difference about the incidence of complications between prostate cancer group and non-prostate group（/r〉0.05）.The sensitivity of DRE and TRUS in prostate cancer group were both higher than it in the non-prostate cancer group （P〈0.05）. Butseparately compared the sensitivity of DRE and TRUS in prostate cancer group and non-prostate cancer gr0up,the difference was significant （P〉0.05）. Conclusion Transrectal uhrasound-guided biopsy combined with serum PSA,digital rectal examination and transrectal ultrasound and PSAD detec- tion,can be more effective guidance for transrectal uhrasound-guided biopsy,with high clinical value, can improve the diagnostic rate.