B超引导10点前列腺穿刺法诊断前列腺癌的结果分析

目的探讨经直肠超声引导下10点法前列腺穿刺活检中前列腺癌阳性结果的分布情况。方法本组473例均因PSA>4ng/ml而进行经直肠超声引导下10点法宝前列腺穿刺活检,穿刺点为在标准的系统6点(前列腺旁正中线矢状切面尖部、中部、底部)的基础上,两外侧各增加2针(外侧周缘中部、底部)。本组患者年龄为41～85岁,平均65岁;PSA水平4.1～444ng/ml,平均15.05ng/ml;前列腺体积8.0～160.0ml,平均42.17ml。对穿刺各针的阳性率及各区域独立出现的阳性率进行分析。结果穿刺总阳性率为26.6%(126/473)。前列腺各穿刺部位的阳性率为:外侧底部23.7%(112/473)、外侧中部20.7%(98/473)、底部19.5%(92/473)、中部18.4%(87/473)、尖部23.9%(113/473)。只有该区域出现阳性的分布情况:外侧底部8.7%(11/126)、外侧中部5.6%(7/126)、底部2.4%(3/126)、中部3.2%(4/126)、尖部7.1%(9/126)。各穿刺部位的阳性率具有统计学差异(P<0.01)。结论经直肠超声引导下经直肠前列腺10点法穿刺活检术可明显提高前列腺癌的临床检出率。其前列腺的尖部、外侧底部和外侧中部的穿刺阳性率要比其他部位高。

Evaluate of transrectal ultrasonography-guided systematic 10 cores prostate biopsy for prostate cancer dectection

Objective To evaluate the clinical value of transrectal ultrasonography-guided systematic 10 cores prostate biopsy. Methods Total 473 patients with prostate specific antigen>4ng/ml underwent transrectal ultrasonography-guided systematic 10 cores prostate biopsy.In addition to standard sextant biopsies,4 cotes were taken from the far lateral regions of the gland as described by Eskew. In these patients age was between 41 years and 85 years,mean 65 years;PSA was between 4.1 ng/ml and 444 ng/ml,mean 15.05ng/ml;and the prostate volume was between 8.0 ml and 160.0 ml,mean 42.17 ml.The cancer detection rate for each biopsy core was calculated. Results Cancer was detected in 126 of 473(26.6%)patients.The positive rate of cores at the base,mild gland,apex,lateral base and lateral mild were 92/473(19.5%),87/473(18.4%),113/473(23.9%),112/473(23.7%),98/473 (20.7%).The unique positive rate of cores at the base,mild gland,apex,lateral base and lateral mild were 3/126(2.4%),4/126 (3.2%),9/126(7.1%),11/126 (8.7%),7/126(5.6%)The cores at the apex,lateral base and lateral mild yielded a high percentage of prostate cancer(P<0.001). The detection rate by 10-core protocol was increased 14.3% than the 6-core protocol.Conclusion Transrectal ultrasonography- guided systematic 10 cores prostate biopsy is efficacious,which can increase the cancer detective rate significantly.The cores at the apex,lateral base and lateral mild yielded a high percentage of prostate cancer.