经直肠超声引导下前列腺穿刺活检540例临床分析

目的评价经直肠超声引导下前列腺穿刺活检诊断前列腺癌（PCa）的临床应用价值，提高PCa的诊治水平。方法回顾性分析血PSA升高和（或）直肠指检前列腺结节及超声检查有异常的540例患者经直肠超声引导下前列腺穿刺活检的临床资料和声像图表现。其中直肠指诊异常者248例；超声显示有异常回声结节者178例，145例为低回声，占81.4％，42例在声像图上未发现异常；380例PSA〉10μg／L。结果540例活检中PCa220例，阳性率为40．7％，前列腺肉瘤4例，前列腺增生症269例，前列腺增生症并上皮内瘤（PIN）35例，前列腺炎9例，前列腺结核2例，非典型增生1例。结论经直肠超声引导下前列腺穿刺活检是诊断PCa的一种安全有效的检查方法。

Clinical analysis of transrectal ultrasound guided needle biopsies of the prostate in 540 patients

Objective To evaluate the clinical value of transrectal ultrasound （TRUS） guided biopsies in patients with elevated serum prostate-specific antigen and/or abnormal digital rectal examination findings. Methods The characteristics of clinical data and the sonography were analyzed retrospectively of 540 patients with serum PSA〉4.0 μg/L, or with positive rectal examination results, or abnormal findings detected by sonography by TRUS guided sextant biopsy and more cores of the nodule. Digital rectal examination （DRE） found prostatic node in 248 patients; Ultrasonography found abnormal nodules in 178 cases, 145 of which were hypoechoic nodules. 42 patients had no abnormal ultrasonographic findings. Prostate specific antigen （PSA） of 380 patients was more than 10μg/L. Results In these patients, there were 220 PCa （40.7%）, 4 sarcoma, 269 benign prostate hyperplasia （BPH）, 35 prostatic intraepithelial neoplasia （PIN）, 9 prostatitis, 2 tuberculosis and 1 atypical hyperplasia. Conclusion Transrectal ultrasound guided biopsy of the prostate is a safe and effective method to diagnose prostate carcinoma.