超声引导下经会阴定位模板的前列腺饱和穿刺活检

Satnrated transperineal ultrasound guided template prostate biopsy

目的探讨超声引导下经会阴定位模板前列腺饱和穿刺活检的准确性、安全性。方法303例PSA〉4．0ng／ml和（或）DRE异常和（或）前列腺B超、CT或MRI异常者接受经会阴定位模板饱和穿刺活检。年龄35～90岁，平均69．7岁。PSA0．2～3000．0ng／ml，中位数13．7ng／ml。前列腺体积7～190ml，中位数47ml。结果每区活检1～4针，共11～44针，平均23．7针。前列腺癌活检阳性率37．6％（114／303）。PSA0～4．0、4．1～10．0、10．1～20．0、20．1～30．0、30．1～70．0及〉70．0ng／ml者阳性率分别为22．2％（4／18）、8．2％（6／73）、21．6％（22／102）、48．4％（15／31）、68．4％（26／38）及100．0％（41／41）。前列腺体积〈20、20～40、41～60及〉60ml者阳性率分别为68．0％（17／25）、51．4％（54／105）、27．5％（19／69）及23．1％（24／104）。无一例出现严重并发症。结论TRUS引导下经会阴定位模板饱和穿刺活检精确而安全，对于前列腺癌的准确分期有重要意义。

Objective To assess the efficacy and safety of saturation transperineal ultrasound guided template prostate biopsy. Methods In a prospective study, a total of 303 patients（35-90 years old, mean age 69.7） who met the inclusion criteria underwent 11 regions saturation transperineal ultrasound guided template prostate biopsy. The inclusion criteria included prostate-specific antigen （PSA） level of 4.0 ng/ml or greater, abnormal prostate gland finding on digital rectal examination, ultrasound, CT or MRI. The median PSA level was 13.7 ng/ml （range 0.2-3000 ng/ml） and the median prostate volume was 47 ml （range 7-190 ml）. Results Prostate cancer was detected in 114 of 303 patients （37.6%）. The prostate cancer detection rate in groups with PSA 0-4.0, 4.1-10.0, 10. 1-20.0, 20.1-30.0, 30. 1-70.0, and 〉70.0 ng/ml groups was 22.2%（4/18）, 8.2%（6/73）, 21.6%（22/102）, 48.4%（15/31）, 68.4% （26/38） and 100.0%（41/41）, respectively. While cancer detection rate was 68.0% （17/25）,51. 4% （54/105）,27. 5% （19/69）,23. 1% （24/104） of men with prostate volumes less than 20, 20-40, 40-60 and greater than 60 ml. No serious complication occurred during the procedure. Conclusions Saturation transperineal ultrasound guided template prostate biopsy is safe and accurate.