前列腺体积和前列腺特异性抗原密度与前列腺癌检出率的关系

【目的】 探讨经直肠超声引导的前列腺穿刺中前列腺体积(PV)、前列腺特异性抗原密度(PSAD)与前列腺癌(Pca)检出率之间的关系。 【方法】 分析2008年7月至2011年5月间在我院行前列腺穿刺262例患者的临床资料,了解PSAD、PV与Pca检出率之间的关系。所有穿刺病例在行穿刺术前均行前列腺特异性抗原(PSA)、直肠指诊(DRE)及经直肠超声(TRUS)扫描测量PV水平并计算得出前列腺特异性抗原密度(PSAD)。 【结果】在总计262例前列腺穿刺的病例中,有101例经病理确诊为Pca,检出率为38.55%。PV分段检出率:PV小于20 mL的Pca检出率为53.33%(8/15);PV在20 mL至30 mL之间检出率为72.73%(24/33);PV在30 mL至50 mL之间的检出率为36.26%(33/91);PV超过50 mL的检出率为29.27%(36/123)。以PSAD = 0.15 ng/mL2为界点,诊断Pca的敏感度47%,特异度90%。【结论】随着PV的增大, Pca的检出率会逐渐下降,所以根据PV大小合理确定穿刺针数,可以提高Pca的检出率,减少漏诊的可能。

Relationship of Prostate Cancer Detection Rate with Prostate Specific Antigen Density and Prostate Volume in Prostate Biopsy

【Objective】To investigate the relationship between the detection rate of prostate cancer (Pca) with prostate specific antigen density (PSAD) and prostate volume (PV) in prostate biopsy.【Methods】 The data of 262 patients who received transrectal ultrasound (TRUS) guided prostate biopsy in our hospital from July 2008 to May 2011 were prospectively collected and analyzed. The measurement of PSA, DRE, TRUS, and PSAD were performed in all patients before TRUS guided prostate biopsy. 【Results】 There were 101 patients who were diagnosed as Pca among 262 patients with the detection rate of 38.55%. The detection rates of Pca were 53.33% and 72.73% in the patients with PV < 20 mL group and PV ranging from 20 to 30 mL respectively, which had a significantly difference to the detection rates of 23.53% and 25.42% in the patients with PV ranging from 30 to 50 mL group and PV > 50 mL group, respectively. On the other hand, with the threshold of 0.15 ng/mL2 in PSAD, the sensitivity and specificity of detection rate are 47% and 90% respectively. 【Conclusion】 The detection rate of Pca is lower with the increase of the PV. To increase the detection rate of Pca, more cores of biopsy are necessary for larger prostate.