前列腺穿刺组织条长度质量的研究

Study on the length and quality of prostate biopsy tissue strips

目的:为了提高前列腺穿刺活检的诊断率,可以通过穿刺更多的部位和针数来实现,另一种获取更多组织的方法是采集更长的组织条。在这项研究中,评估了组织条长度对穿刺活检诊断癌症的影响,并得出一个能提高癌症检出率的组织条长度临界值。方法:回顾性分析苏北人民医院754例患者因可疑前列腺癌行经会阴前列腺穿刺的病理报告。对年龄、血清PSA、前列腺体积、Gleason评分和组织条长度进行处理分析。比较活检阳性患者和活检阴性患者的组织条长度,并分别将其分为A组(活检阳性)和B组(活检阴性)。统计分析组织条长度以确定活检长度质量的截止值。结果:754例患者共取组织条10556条,有45.1%的患者病理报告为前列腺癌。所有病例的总组织条中位长度10.5(9.5,12.5)mm,中位年龄为69(64,75)岁,中位PSA值为12.4(8.6,20.8)μg/L,中位前列腺体积为44.8(30.5,64.4)ml。A组和B组的组织条中位长度分别为11(10,13)mm和10(9,12)mm。对所有病例的组织条长度进行受试者工作特征曲线(ROC)分析计算,得出组织条质量保证的截止值为11.8 mm,曲线下面积(AUC)为0.82,灵敏度71.4%,特异性73.8%,差异有统计学意义(P<0.001)。结论:在经会阴前列腺穿刺中,组织条的癌症检出率可能随着长度的增加而增加。ROC分析结果表明组织条长度11.8 mm作为质量保证的截止值。

Objective:To improve the diagnostic yield of prostate biopsy,which we can achieve by puncture more sites and number of cores,another way to obtain more tissue is to take longer tissue strips.In this study,we evaluated the effect of strip length on cancer diagnosis by needle biopsy and derived a cutoff value of strip length to improve cancer detection.Methods:The pathological reports of 754 patients with suspected prostate cancer who underwent transperineal prostate biopsy were retrospectively analyzed.The age,serum prostate specific antigen(PSA),prostate volume,Gleason score and tissue strip length were analyzed.The length of the tissue strip was compared between the biopsy positive patients and the biopsy negative patients,and the patients were divided into group A(biopsy positive group)and group B(biopsy negative group),respectively.Statistical analysis of tissue strip lengths was performed to determine cutoff values for biopsy length quality.Results:A total of 10556 tissue strips were obtained from 754 patients,and 45.1%of the patients were pathologically diagnosed as prostate cancer.The median length of the tissue strip was 10.5(9.5,12.5)mm,the median age was 69(64,75)years,the median PSA was 12.4(8.6,20.8)μg/L,and the median prostate volume was 44.8(30.5,64.4)ml.The median length of tissue strips in group A and group B was 11(10,13)mm and 10(9,12)mm,respectively.Receiver operating characteristic(ROC)curve analysis was performed on the length of tissue strips in all cases,and the cutoff value of quality assurance was 11.8mm,the area under curve(AUC)was 0.82,and the cut-off value of quality assurance was 11.8mm.Sensitivity 71.4%,specificity 73.8%(P<0.001).Conclusions:In transperineal prostate biopsy,the cancer detection rate of tissue strips may increase with length.The results of ROC analysis showed that 11.8 mm was used as the cut-off value for quality assurance.