个体化前列腺穿刺活检方案的选择

【目的】探讨针对不同的前列腺体积及血清前列腺特异性抗原（PsA）水平采用不同的前列腺系统穿刺活检方案的临床价值。【方法】对153例患者进行经直肠彩超引导下前列腺15针系统穿刺活检术，通过选择不同的穿刺部位及针数，形成6针法、8针法、10针法、12针法及15针法，分析、比较不同针法及在不同PSA水平、不同前列腺体积中的检出率。【结果】共检出前列腺癌患者59例，6针法检出率72．9％（43／59），12针法检出率98．3％（58／59）；总PSA（TPSA）〉100ng／mL的前列腺癌患者15例，6针法全部检出无漏诊；前列腺体积〈40mL组，8针法检出率100％（22／22），前列腺体积〉40mL组，12针法检出率97．4％（37／38）。【结论】前列腺系统穿刺活检方案应根据不同的前列腺体积及血清TPSA水平选定。

Individual Option of Prostate Biopsy Approaches

Objective]To explore the clinical value of different approaches of prostate biopsy based on different volume of prostate and different level of serum prostate specific antigen（PSA）. Methods] Totally 153 cases undertook 15-core transrectal ultrasound-guided needle biopsy. The methods of 6-core, 8-core, 10-core, 12-core and 15-core were respectively selected by different puncture positions and cores. The data was retro- spectively analyzed. The detection rate was compared among different cores, PSA levels and prostate volume. Results]Fifty nine patients with prostate cancer were detected. The detection rate of 6-core and 12-core methods were 72.9% （43/59） and 98.9% （58/59）, respectively. There were 15 cases of prostate cancer with TPSA 〉100 ng/mL, and the detection rate of 6-core method was 100%, and there was no missed diagnosis. In the group of prostate volume less than 40 mL, the detection rate of 8-core method was 100% （222/22）. In the group of prostate volume more than 40ml, the detection rate of 12-core method was 97. 4% （37/38）. Conclusion] The approaches of prostate biopsy should be chosen based on different volume of prostate and different levels of serum PSA.