超声引导下前列腺6点活检诊断早期前列腺癌

Transrectal ultrasound-directed prostate biopsy can detect early prostate cancer

目的探讨前列腺癌(PCa)的超声影像与超声引导下6点系统活检病理学检查的关系,提高早期PCa检出率。方法研究对象为PCa集团普查发现的血清PSA>4.0ng/ml的329例经直肠超声引导下前列腺活检受检者,每位受检者均行血清PSA检测及前列腺活检病理诊断。结果(1)329例接受前列腺活检病例中PCa患者93例(28.3%),其中前列腺腺癌88例,其他类型癌5例。(2)93例PCa患者的超声影像中见低回声反射区组为56例(60.2%),其余37例为无异常回声组(39.8%)。(3)88例前列腺腺癌中,53例低回声反射区组PSA平均值为(60.50±39.79)ng/ml,35例无异常回声组PSA平均值为(12.74±8.25)ng/ml,两组比较差异显著(P<0.001)。PSA含量4.0￣10.0ng/ml区间者17例,无低回声反射区者15例,占88.2%。(4)早期病例(A,B期)中无异常回声组占82.9%。结论在超声影像学无异常的血清PSA增高的人群中,经超声引导下前列腺活检能够发现早期PCa。

Objective To investigate the relationship between ultrasonic findings of prostate cancer and transrectal ultrasound （TURS）-directed prostate biopsy. Methods 329 men with PSA value above 4.0 ng/mL had TRUS biopsies. Results 93 of 329 cases （28.3%） had cancer detected, in which 88 were adenocarcinoma and 5 were other pathologic types. 56 of 93 cases （60.2%） had hypoechoic pattern and 37 of 93 cases （39.8%） had normal echo pattern. 53 cases （adenocarcinoma detected） with hypoechoic pattern had PSA value （60.50±39.79） ng/ml. 35 cases （adenocarcinoma detected） with normal echo pattern had PSA value （12.74±8.25） ng/ml, which is different from the hypoechoic pattern cases（P〈0.001）. 17 cases had PSA value 4.0-10.0 ng/ml, among which 15 cases （88.2%） had normal echo pattern. In cases of early stage （ stage A and B）, 82.9% cases had echo pattern. Conclusion TURS biopsies can achieve early diagnosis of prostate cancer in cases of who had normal echo pattern with increased PSA value.