经会阴前列腺靶向穿刺联合快速病理检查在前列腺癌诊断中的应用

Transperineal targeted prostate puncture combined with rapid pathological examination in the diagnosis of prostate cancer

探索多参数磁共振(Mp-MRI)认知融合法经会阴前列腺靶向穿刺,结合快速病理在前列腺癌诊断中的临床应用价值。回顾性选取2022年1月至2023年5月徐州医科大学附属连云港医院泌尿外科收治的可疑前列腺癌患者作为研究对象,行Mp-MRI检查并对可疑病灶予以前列腺影像报告和数据系统(PI-RADS)评分。入组患者数字随机分为经会阴前列腺靶向穿刺+快速病理组(试验组)和经会阴前列腺系统联合靶向穿刺+常规病理组(对照组),分析两组的穿刺阳性率、病理结果、并发症等资料的差异。入组患者共100例,年龄55~89岁,试验组53例[年龄55~89(73.17±7.79)岁,总前列腺特异性抗原(tPSA)7.01~100μg/L,21.34(12.38,44.42)μg/L]和对照组47例[年龄60~87(71.96±7.07)岁;tPSA 6.11~98.82μg/L,18.77(9.04,38.09)μg/L],两组总体前列腺癌(PCa)、有临床意义PCa的诊断阳性率差异无统计学意义(P>0.05);两组病理组织Gleason评分对比差异无统计学意义(P>0.05);试验组术后肉眼血尿例数较对照组减少(P<0.05);在活检疼痛视觉模拟评分(VAS)方面,试验组较对照组承受更少的疼痛体验(P<0.05)。提示Mp-MRI认知融合法经会阴前列腺靶向穿刺结合快速冰冻切片病理检查可快速、准确获知病理结果,降低穿刺术后并发症的发生率,同时减轻穿刺取样引起的疼痛,有较高的临床应用价值。

Exploring the clinical value of multiparametric magnetic resonance(Mp-MRI)-cognitive fusion method of targeted transperineal prostate puncture combined with rapid pathological diagnosis.Patients with suspected prostate cancer admitted to our hospital from 2022.01 to 2023.05 were selected as the study subjects,and Mp-MRI was performed and the suspected lesions were scored by the Prostate Imaging Reporting and Data System(PI-RADS).The enrolled patients were randomly divided into the transperineal prostate targeted puncture plus rapid pathology group(experimental group)and the transperineal prostate systematic combined targeted puncture plus conventional pathology group(control group),and the positive puncture rate,pathological findings,and complications were analyzed to compare the differences between the two groups.A total of 100 patients were enrolled,53 in the experimental group[age 55-89 years,(73.17±7.79)years;tPSA 7.01-100μg/L,mean 21.34(12.38,44.42)μg/L]and 47 in the control group[age 60-87 years,(71.96±7.07)years;tPSA 6.11-98.82μg/L,mean 18.77(9.04,38.09)μg/L],and there was no significant difference between the two groups in the diagnostic positivity rate of overall PCa and clinically significant PCa(P>0.05);there was no significant difference in the highest Gleason score of pathological tissues between the two groups(P>0.05);the number of cases of medically induced sarcoid hematuria in the experimental group were significantly reduced compared with the control group(P<0.05).In terms of biopsy pain score(VAS),patients in the experimental group experienced less pain than those in the control group(P<0.05).The Mp-MRI-cognitive fusion method of transperineal targeted prostate puncture combined with rapid frozen section pathological examination can provide rapid and accurate pathological results,reduce the chance of post-puncture complications,and alleviate the pain caused by puncture sampling,which has high clinical value.