经直肠超声引导13点前列腺系统穿刺活检术

目的　探讨经直肠超声引导 13点前列腺系统穿刺活检术诊断前列腺癌的临床价值。方法　 35 6例直肠指诊阳性和 (或 )PSA >4ng ml的患者接受了经直肠超声引导 13点前列腺系统穿刺活检术。即在标准的经直肠超声引导 6点前列腺系统穿刺活检术的同时 ,增加前列腺中间部位及前列腺两侧旁正中线远侧的穿刺点数 ,总共穿刺活检样本数为 13个点。将增加的 7点活检部位的病理结果与标准的 6点前列腺穿刺活检术进行比较。结果　 35 6例患者中确诊为前列腺癌者 10 7例 (30 % )。 10 7例患者若只接受 6点穿刺方法 ,将有 2 1例患者漏诊 ,约占 2 0 %。 35 6例接受13点穿刺的患者均未出现严重的并发症。结论　经直肠超声引导 13点前列腺系统穿刺活检术可明显提高前列腺癌的临床检出率 ,值得临床推广应用。

Transrectal ultrasound guided systematic 13 cores prostate biopsy

Objective To evaluate the clinical value of transrectal ultrasound guided systematic 13 cores prostate biopsy. Methods Total 356 patients with abnormal digital rectal examination and/or prostate specific antigen >4 ng/ml underwent transrectal ultrasound guided systematic 13 cores prostate biopsy. In addition to standard sextant biopsies,cores were taken from the far lateral and middle regions of the gland as described by Eskew. Pathological findings of the additional regions were compared with those of the sextant regions. Results Of 356 patients, 107 (30%) had cancer on biopsy. Of the 107 patients with prostate cancer, only 21(20%) had carcinoma in the additional regions. No severe complication was found among the patients who underwent transrectal ultrasound guided systematic 13 cores prostate biopsy. Conclusions Transrectal ultrasound guided systematic 13 cores prostate biopsy can increase the cancer detective rate significantly, which is safe and efficacious.