经尿道等离子前列腺电切在诊断前列腺穿刺活检阴性的前列腺癌患者中的作用

目的探讨经尿道等离子前列腺电切术（PKRP）在前列腺穿刺活检阴性的前列腺增生症患者中，诊断前列腺癌的重要临床意义。方法回顾性分析50例行经尿道等离子电切术（PKRP）患者．按不同的治疗措施随机分为两组：组1PKRP术前行经直肠超声（TRUS）前列腺穿刺活检阴性者，其中术后证实为前列腺癌者为组1A，术后证实为良性前列腺增生者为组1B；组2PKRP术前未行穿刺活检者。同时检测所有患者前列腺特异性抗原（PSA）、直肠指检（DKE）、前列腺切除量、术后病理、TRUS穿刺活检结果。结果两组对前列腺癌的检出率（组1：14％，组2：8．5％）有显著性差异（P〈0．05）。其中组1中A组和B组间前列腺体积、移行区体积，PSA和PSAD值无显著性差异（P〉0．05）：TRUS低回声区发生率两组间比较有显著性差异（P〈0．01）。异常直肠指检（DIKE）有显著性差异（P〈0．05）。前列腺癌的检出率与PSA值呈正相关性。结论经尿道等离子前列腺电切术（PKRP）对疑有前列腺癌和良性前列腺增生症患者都具有良好手术效果和安全性，而且对诊断前列腺活检穿刺阴性的前列腺癌具有重要的作用。

The Role of Transurethal Bipolar Plasmakentic Resection in Detection of Negative Prostate Biopsy Prostate Cancer Patients

Objective To investigate the clinical significance of transurethal bipolar plasmakentic resection in the detection negative prostate biopsy prostate cancer patients. Methods Retrospective analysis 50 cases of transurethal bipolar plasmakentic resection patients. According to different treatments were randomly divided into two groups. The prostate cancer detection rate was compared between patients who underwent TRUS biopsy before PKRP （group 1） and those who did not （group 2）. Group 1 was subdivided into group A （who were diagnosed with prostate cancer） and group B （who were diagnosed with BPH after PKRP）. Simultaneous detection of prostate specific antigen （PSA）, digital rectal examination （DRE）, prostate PKRP resection volume and pathology report, TRUS, TRUS biopsy results. Results The cancer detection rate had significant difference between groups 1 （14%） and 2（8.5%） （P 〈 0.05）. PSA, PSAD, prostate PKRP resection volume, transition zone volume had no significant difference between Group A and Group B. Digital rectal examination （DRE） and TRUS hypoechoic lesion had significant difference （P 〈 0.05）. The detection rate of prostate cancer with PSA values showed positive correlation. Conclusion PKRP has a good efficacy and safety on prostate cancer and BPH patients, and has an important role to diagnose negative prostate biopsy prostate cancer patients.