超声引导13点前列腺穿刺活检对前列腺癌的诊断研究

Transrectal ultrasound guided systematic 13 core prostate biopsy for diagnosing prostate carcinoma

目的探讨经直肠超声引导下13点前列腺系统穿刺活检对诊断前列腺癌的临床价值。方法 255例直肠指诊阳性和(或)PSA>4ng/ml患者全部行13点前列腺系统穿刺活检。在标准6点前列腺系统穿刺活检术的同时,增加前列腺中间部位及前列腺两侧旁正中线远侧的穿刺点数,总活检13点。将增加的7点活检部位的病理结果与标准6点活检术病理结果进行比较。结果 255例患者中确诊为前列腺癌者71例(28%),这71例前列腺癌患者若只接受6点穿刺方法,将有15例患者漏诊,约占21%。所有行13点穿刺患者均未出现严重并发症。结论直肠超声引导下13点前列腺系统穿刺活检术可明显提高前列腺癌的临床检出率,并且无严重并发症,可广泛临床推广。

Objective To evaluate the clinical value of transrectal ultrasound guided systematic 13 core prostate biopsy. Methods A total of 255 patients referred to abnormal digital rectal examination and/or prostate specific antigen 4ng/ml or greater underwent transrectal ultrasound guided systematic 13 core prostate biopsy. That was,in addition to standard sextant biopsies, cores were taken from the far lateral and middle regions of the gland as described by Eskew. Pathological findings of the additional regions were compared with those of the sextant regions.Results Of the patients 28% had cancer on biopsy （71/255）.Of the 71patients with prostate cancer 15（21%）had carcinoma only in the additional regions, which would have remained undetected had the sextant biopsy technique been used alone （P〈0.05）.No one of severe complications could be found among the patients who underwent transrectal ultrasound guided systematic 13 core prostate biopsy.Conclusion Our data demonstrated that transrectal ultrasound guided systematic 13 core prostate biopsy can increase the detection rate significantly. It is safe and efficacious, and should be recommended to be used in clinic.