超声引导下经直肠系统性12+1针前列腺穿刺活检术

Transrectal ultrasound guided systematic 12+1 cores prostate biopsy for the diagnosis of prostate carcinoma

目的探讨超声引导下经直肠系统性12+1针前列腺穿刺活检术诊断前列腺癌的临床价值。方法回顾性分析816例经直肠前列腺系统性12+1针穿刺活检的可疑前列腺癌患者。其中PSA<4ng/ml、直肠指诊发现结节者66例;PSA介于4～10ng/ml、f/tPSA值异常、PSAD值异常者190例;PSA>10ng/ml、任何f/tPSA、PSAD值者560例。结果 816例患者中活检病理确诊为前列腺癌者358例,总阳性率为43.9%(358/816)。其中位于前列腺尖部阳性者235例,占确诊病例总数的65.6%(235/358)。术后发热9例(1.0%,9/816),并发血尿49例(6.0%,49/816)。几乎所有患者皆有短时大便带血。无其他严重并发症发生。结论超声引导下经直肠系统性前列腺12+1针穿刺活检术定位准确,创伤较小,并发症较少。可以随机增加穿刺点,利于提高前列腺癌检出率。

Objective To evaluate the clinical value of transrectal ultrasound guided systematic 12 ＋ 1 cores prostate biopsy. Methods A total of 816 patients from July 2006 to November 2012 were retrospectively analyzed. It was found that 66 cases of abnormal digital rectal examination and the prostate specific antigen （PSA）〈4 ng/rnl. The 190 cases of PSA between 4 ng/ml to 10 ng/ml and f/t PSA and the prostate specific antigen density were abnormal The cases of the PSA〉10 ng/ml were 560. Results Of the patients 43.9% had cancer on biopsy （358/816）. The 235 cases of positive located in the prostatic apex, accounting for 65.6% in total cancer （235/358）. Of the patients 1.0% had fever （9/ 816） and 6.0 % had concurrent hematuria （49/816）. Almost all patients had short-term blood in the stool. No other serious complication occured. Conclusions Transrectal ultrasound guided systematic 12＋ 1 cores prostate biopsy would enhance significantly the cancer detection rate.