经直肠超声引导下前列腺穿刺活检的临床应用价值

Clinical Value of Transrectal Ultrasound Guided Biopsy of the Prostate

目的:探讨经直肠超声引导下前列腺穿刺活检的临床价值。材料和方法:578例临床疑似前列腺癌(PCA)患者(PSA>4μg/L、直肠指检发现前列腺结节、影像学发现异常)在经直肠超声引导下对前列腺行"6+X"或"12+X"法穿刺活检。结果:经直肠超声引导下前列腺穿刺活检病理诊断前列腺癌共221例,穿刺阳性率38.2%,良性前列腺增生(BPH)共357例(61.8%);随着PSA水平升高,穿刺阳性率逐步升高;游离PSA与总PSA的比值<0.16者穿刺阳性率高于比值>0.16者。主要并发症为:血尿(25.2%)、大便带血(16.7%)、发热(15.6%)。结论:经直肠超声引导下前列腺穿刺活检有助于前列腺疾病的鉴别诊断,游离PSA与总PSA的比值对于穿刺病理结果有一定预测价值。

Purpose：To investigate the efficiency and to summarize the experience of ultrasound guided transrectal prostate biopsy. Materials and Methods：578 suspected of prostatic carcinoma （ PCA ） underwent transrectal prostate biopsy under ulsound guidance with 6 plus X or 12 plus X biopsy method. Results： Pathology proved PEA in 221 cases （ 38.2 % ） , and benign hyperplasia （BPH）in 357（61.8%）. The most common complications are hematuria, bleeding and fever. Conclusion ： The combination of PSA, f/T ration will increase positive biopsy rate. Ultrasound guided transrectal biopsy of the prostate, is an easy, safe and efficient method in diagnosis of prostate cancer.