前列腺靶向穿刺活检并脱落细胞学检查在前列腺癌诊断中的应用

The Application of Prostate Targeted Biopsy and Abscission Cytology for the Diagnosis of Prostate Cancer

目的探讨前列腺靶向穿刺活检并脱落细胞学检查在前列腺癌诊断中的应用.方法回顾性研究作者单位自2016年11月至2018年8月超声引导下前列腺穿刺活检患者104例,年龄46~87岁.穿刺时行超声与磁共振图像融合,图像匹配后进行靶向穿刺.穿刺过程中将穿刺标本直接压片到事先准备好的载玻片上,做好标记,同条标本用4%甲醛固定送病理学检查.带有前列腺细胞的载玻片行瑞氏染色,显微镜下观察寻找脱落的肿瘤细胞.结果本组104例患者中,总的前列腺癌检出率62.5%(65/104),年龄分组间及各PSA分组间穿刺阳性率的比较差异均有统计学意义(P<0.05).MRI异常信号患者前列腺癌检出率61.3%(46/75),与总前列腺穿刺活检阳性率62.5%(65/104)相比,差异无统计学意义(P>0.05).系统穿刺患者脱落细胞学检测阳性率30.8%(32/104),与MRI异常信号患者前列腺脱落细胞学检测阳性率58.7%(44/75)相比,差距有统计学意义(P<0.01).结论超声引导下前列腺靶向穿刺诊断前列腺癌准确性高.前列腺穿刺活检过程中脱落细胞学检测在基层医院可作为推广.

Objective To investigate the application of prostate-targeted biopsy and abscission cytology in the diagnosis of prostate cancer.Methods A retrospective study was conducted on 104 patients aged from 46 to 87 years old who underwent prostate targeted biopsy in our hospital from November 2016 to August 2018.The ultrasound and magnetic resonance images were fused during the biopsy,and the targeted biopsy was performed after the image matching.During the biopsy,the biopsy specimen was directly pressed onto the prepared slide,marked,and the same specimen was fixed with 4%formaldehyde for pathological examination.A slide with prostate cells is stained with Wright's stain and examined under a microscope looking for the exfoliated tumor cells.Results Among the 104 patients in this group,the total positive rate of prostate cancer was 62.5%(65/104),and the differences in biopsy positive rate between age groups and PSA groups were statistically significant(P<0.05).The positive rate of prostate cancer in patients with MRI abnormal signal was 61.3%(46/75),and the positive rate of total prostate biopsy was 62.5%(65/104),with no statistical significance(P>0.05).There was a statistically significant difference between 30.8%(32/104)of patients with systematic biopsy and 58.7%(44/75)of patients with MRI abnormal signal(P<0.01).Conclusions Ultrasound-guided targeted prostate biopsy is of high accuracy in the diagnosis of prostate cancer.Abscission cytology in prostate biopsy can be used in primary hospitals.