经直肠超声引导前列腺13点系统穿刺活检术诊断前列腺癌

The transrectal ultrasound guided systematic 13 cores prostate biopsy diagnosing prostate carcinoma:report of 160 cases

目的 探讨经直肠超声引导前列腺 13点系统穿刺活检术诊断前列腺癌的临床价值。方法 共16 0例直肠指诊阳性和 (或 )前列腺特异抗原 (PSA)值 >4ng/ml的患者接受了经直肠超声引导前列腺 13点系统穿刺活检术 ,即按照Eskew描述的方法 ,在标准的经直肠超声引导前列腺 6点系统穿刺活检术的同时 ,增加在前列腺的中间部位及前列腺两侧旁正中线远侧的穿刺点数 ,共穿刺活检 13点。将增加的 7点活检部位的病理结果与标准的 6点穿刺活检术进行比较。结果 16 0例患者中有 5 6例确诊为前列腺癌 ( 5 6 / 16 0 ) ,占 35 %。 5 6例前列腺癌患者若仅采用标准的经直肠超声引导 6点前列腺穿刺活检术 ,将有 12例患者漏诊 ,占 2 1%。所有接受经直肠超声引导前列腺 13点系统穿刺活检术的患者无一例出现严重的并发症。结论 经直肠超声引导前列腺13点系统穿刺活检术可明显提高前列腺癌的临床检出率 ,是一种安全、有效的前列腺系统穿刺活检术式 ,值得在临床推广应用。

Objective To evaluate the clinical value of transrectal ultrasound guided systematic 13 cores prostate biopsy.Methods A total of 160 patients referred for abnormal digital rectal examination and/or prostate specific antigen (PSA)4 ng/ml or greater underwent transrectal ultrasound guided systematic 13 cores prostate biopsy.That was,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 the patients 35% had cancer on biopsy(56/160).Of the 56 patients with prostate cancer 12 (21%) had carcinoma only in the additional regions,which would have remained undetected,had the sextant biopsy technique been used alone(P< 0.05).No one of severe complications could be found among the patients who underwent transrectal ultrasound guided systematic 13 cores prostate biopsy.Conclusions Transrectal ultrasound guided systematic 13 cores prostate biopsy could increase the cancer detection rate significantly.This technique is safe and efficacious,and should be recommended to be used in clinic.