超声引导前列腺12针系统穿刺活检术

目的　探讨经直肠超声引导下前列腺12针系统穿刺活检术诊断前列腺癌的临床价值。　方法　对220例行经直肠B超引导下前列腺12针(在传统6针基础上增加前列腺两侧外周带外侧底、中、尖部各1针)系统穿刺活检术的患者资料进行回顾性分析。　结果　前列腺癌患者73例(33. 2% ),临床分期T1 4例、T2 21例、T3 15例、T4 33例,如按传统6针穿刺方法穿刺,检出率为31. 4%,将有4例早期癌(T1 3例、T2 1例,体积均<0. 5ml)患者漏诊, 6针较12针穿刺漏诊早期癌16% (4 /25)。220例患者均未出现严重并发症。　结论　12针较6针系统穿刺活检可以增加早期癌和小体积癌( <0. 5ml)的检出,应重视对前列腺外周带外侧6点的穿刺。

Transrectal 12-core biopsy of the prostate guided by transrectal ultrasonography

Objective To evaluate the clinical value of transrectal ultrasound guided systematic 12-sample needle biopsy in patients with elevated serum prostate-specific antigen and/or abnormal digital rectal examination findings. Methods The data of 220 patients who underwent 12-sample transrectal ultrasound guided needle biopsy (comprising conventional 6 biopsies and 3 biopsies in each lateral peripheral zone) of the prostate were retrospectively analyzed. Results Of the 220 patients,73 (33.2%) had prostate cancers on biopsy;the clinical stages were as follows:4 cases of stage T 1,21 of T 2,15 of T 3 and 33 of T 4.If the conventional 6-core biopsy alone was performed, the detection rate would be 31.4%,4 cases (3 of stage T 1 and 1 of stage T 2,all with tumor volume less than 0.5 ml) would be missed. The improvement by 12-core biopsy was marked in patients with stage T 1-T 2 prostate disease (16%,4/25).No serious complications were observed in patients with transrectal ultrasound guided systematic 12-core biopsy of the prostate. Conclusions The 12-sample procedure can improve the cancer detection rate of the early stage prostate cancer and tumor with volume less than 0.5 ml.Therefore,more attention should be paid to the lateral peripheral zone biopsy.