214例前列腺穿刺结果的前列腺癌病灶分布情况分析

Distribution of prostate carcinoma foci within the peripheral zone:analysis of 214 prostate biopsy results

目的探讨经直肠超声引导下经直肠前列腺穿刺活检结果的前列腺癌病灶分布情况。方法本组214例,其中214例前列腺特异抗原＞4．0ng/ml 203例,直肠指诊可疑前列腺癌41例；均行13针前列腺穿刺活检术。入选病例的年龄为50～90岁,平均69．8岁；PSA水平0．8～112．3ng/ml,平均18．7 ng/ml；前列腺体积12．3～182．5ml,平均61．3 ml；直肠指诊阴性者173例,阳性者41例。分析各穿刺部位的阳性率。结果5区13针法的阳性率为36．0%(77/214)。前列腺各穿刺部位的阳性率为：底部48/214(22．4%)、中部57/214(26．6%)、尖部57/214(26．6%)、外侧底部47/214(22．0%)、外侧中部61/214(28．5%)。各穿刺部位的阳性率的差异具有显著性(P＜0．001)。结论前列腺穿刺活检发现的前列腺癌病灶分布不均匀。前列腺的尖部、中部和外侧中部的穿刺阳性率较其它部位高。

Objective To evaluate the distribution of prostate cancer within the peripheral zone by prostate biopsies. Methods 214 consecutive men with suspected prostate cancer were included in the study. Indications for TRUS guided prostate biopsy were： abnormal digital rectal examination（DRE） （41 cases） and/or a total prostate specific antigen （PSA） over 4.0ng/ml （203 cases）, In these candidates age was between 50 years and 90 years, mean 69.8 years; PSA was between 0.8 ng/ml and 112.3ng/ml, mean 18.7 ng/ml; and the prostate volume was between 12.3ml and 182.5ml, mean 61.3ml. DRE was negative in 173 cases and positive in 41 cases, The cancer detection rate for each biopsy core was calculated. Results Cancer was detected in 77 of 214 （36%） patients, The positive rate of cores at the base, mild gland, apex, lateral base and lateral mild were 48/214（22.4%）, 57/214（26,6%）, 57/214（26.6%）, 47/214（22.0%） and 61/214（28.5%）. The cores at the apex, mid gland and lateral mid yielded a high percentage of prostate cancer （P〈0.001）, Conclusion Our data suggest that the distribution of cancer foci detected by biopsies in the peripheral zone of the prostate is heterogeneous. The cores at the apex, mid gland and lateral mid yielded a high percentage of prostate cancer.