超声引导下经不同针数直肠前列腺穿刺活检对前列腺癌的早期诊断效果对比

目的探讨超声引导下经直肠前列腺穿刺活检在诊断前列腺癌的价值。方法选取2013年1月至2016年12月在本院就诊的疑似前列腺癌患者62例,均超声引导下经直肠前列腺穿刺活检,分析不同穿刺法的阳性检出情况。结果本组研究62例患者,穿刺活检病理结果为前列腺癌患者25例（40.32%）,其中34例接受10针法穿刺,28例接受12+1针法穿刺,两种穿刺的阳性率分别为35.29%（12/34）和46.43%（13/28）,差异无统计学意义（P＞0.05）;前列腺体积≥90 mL患者10针法阳性检出率为33.33%（5/15）,明显低于12+1针法的87.50%（7/8）,差异比较有统计学意义（P＜0.05）;10针法和12+1针法在不同年龄、前列腺特异性抗原（PSA）及指诊情况下阳性检测率比较差异无统计学意义（P＞0.05）;10针法和12+1针法穿刺后血尿、血便、疼痛、尿潴留及感染发生比例差异比较无统计学意义（P＞0.05）。结论 应根据患者具体情况选取穿刺方法,当患者前列腺体积超过90 mL时,应采取12+1针法穿刺,有助于前列腺癌的检出,而当＜90 mL时,选取10针法穿刺较适宜。

Analysis of positive detection,pain degree and safety of ultrasound guided transrectal prostate biopsy for early diagnosis of prostate cancer

Objective  To evaluate the value of transrectal ultrasound guided prostate biopsy in the diagnosis of prostate cancer.Methods  A total of 62 patients with suspected prostate cancer in our hospital from January 2013 to December 2016 were selected, and all patients were examined by transrectal ultrasound guided transrectal prostate biopsy. Positive detection of different puncture methods was analysed. Results   Biopsy results were 25 cases of prostate cancer (40.32%).Of the 62 patients, 34 patients underwent 10 needle puncture, 28 patients underwent 12+1 needle puncture,the positive rate of the two kinds of puncture was 35.29% and 46.43%,respectively. The difference was not statistically significant (P>0.05). Positive detection rate of 10 needle puncture in patients with prostate volume ≥90 mL was 33.33%（5/15）, which significantly lower than the 12+1 needle puncture 87.50%(7/8), the difference was statistically significant (P<0.05).There was no statistically significantly difference in different age, prostate specific antigen (PSA) and rectal examination the positive detection rate between 10 needle puncture and 12+1 needle puncture (P>0.05).There was no statistically significantly difference in hematuria, bloody stool, pain,urinary retention and infectionratio between 10 needle puncture and 12+1 needle puncture after the puncture (P>0.05). Conclusions  According to the specific circumstances of patients, the puncture method is selected, when patients with prostate volume more than 90 mL, we should adopt 12+1 needle puncture for diagnosis of prostate cancer, and when the < 90 mL, 10 needle puncture is a suitable method.