经直肠超声引导下经会阴前列腺穿刺315例分析

目的 探讨经直肠超声（TRUS）引导下经会阴前列腺穿刺的临床意义。方法 对315例PSA〉4ng／ml、直肠指检异常或B超发现异常回声的患者行经会阴的6点系统加异常回声处活检。年龄43～91岁，平均72岁。PSA〈4ng／ml者66例，4～10ng／ml者96例，10～20ng／ml者90例，〉20ng／ml者63例。结果 穿刺活检证实为前列腺癌111例，阳性率35．2％。PSA〉4ng／ml、指检异常、B超发现异常回声及PSAD〉0．15者穿刺阳性率分别为43．4％（108／249）、42．9％（75／175）、32．8％（63／192）及52．1％（75／144）。以PSAD〉0．15时的阳性率为最高，与其余3种标准相比差异有统计学意义。结论 TRUS引导下经会阴前列腺穿刺准确率高，并发症少而轻，是诊断前列腺癌的重要方法。

TRUS guided transperineal biopsy of the prostate with auto-biopsy gun ( analysis of 315 cases)

Objective To investigate the clinical significance of TRUS guided transperineal biopsy of the prostate with auto-biopsy gun.Methods A total of 315 patients(mean age,72 years;age range,43-91 years) with serum PSA>4 ng/ml or positive rectal examination results or abnormal B-ultrasonography findings underwent transperineal sextant biopsy and more cores of the nodules.Of the 315 cases,66 had the PSA level below 4 ng/ml;96,from 4 to 10 ng/ml;90,from 10 to 20 ng/ml,and 63,above 20 ng/ml.Results The biopsy results confirmed the diagnosis of prostate cancer in 111 cases,with a positive rate of(35.2)%.The positive rates of biopsy with the 4 parameters(including PSA>4 ng/ml,abnormal findings on DRE,abnormal echo on TRUS and PSAD>0.15) were 43.4%(108/249),42.9%(75/175),32.8%(63/192) and 52.1%(75/144),respectively.Biopsy with PSAD>0.15 had the highest positive rate,which showed significant differences compared with those of the 3 other parameters.Conclusions TRUS guided transperineal biopsy is an ideal method for the diagnosis of prostate cancer with a high accuracy rate and fewer complications.