超声引导下经直肠前列腺穿刺活检560例分析

Transrectal ultrasonography-guided prostate biopsy in 560 consecutive patients

目的：探讨15针经直肠超声引导下前列腺穿刺活检术诊断前列腺癌的临床价值及其安全性。方法：回顾性分析我院2010-01—10—2012—12—20560例初次行经直肠超声引导下前列腺穿刺活检术的可疑前列腺癌患者的临床资料，对穿刺结果及穿刺后并发症情况做相关分析。结果：560例穿刺患者平均年龄（67．34±9．75）岁，平均前列腺特异性抗原（prostatespecificantigen，PSA）水平为（8．41±33．45）μg／L，平均前列腺体积大小为（64．52±35．47）mL，穿刺结果为前列腺癌214例（38．2％），前列腺增生65例（11．6％），前列腺增生伴低级别上皮内瘤变（prostaticintraepithelialneoplasia，PIN）I128例（22．9％），PINII～Ⅲ35例（6．3％），良性前列腺增生（benignprostatichyperplasia，BPH）伴慢性炎症96例（17．1％），腺泡状横纹肉瘤1例。穿刺术后119例出现肉眼血尿（21．3％），尿频、尿急和尿痛18例（3．2％），直肠出血3例（0．5％），急性尿潴留15例（2．7％），发热10例（1．8％），无其他严重并发症。结论：经直肠超声引导下前列腺15针系统穿刺法穿刺阳性率高，并发症少，是诊断前列腺癌的安全、有效方法，值得推广。

OBJECTIVE： To introduce and discuss the clinical value and safety experience of transrectal ultrasonogra- phy （TRUS）-guided prostate biopsy with 15 sample needle protocol for diagnosis of prostate cancer in our department. METHODS： A total of 560 cases underwent TRUS-guided transrectal biopsy with 15 sample needle protocol for suspected prostate cancer. The clinical data, results and complications were retrospectively analyzed. RESULTS： Of 560 cases, the av- erage age was （67.34±9.75） years,the average PSA level was （8.41±33.45） μg/L,the average volume of the prostate size was （64.52±35.47） mL. Totally 214 cases（38.2%） were diagnosed as PCa. Sixty-five cases of prostate hyperplasia （11.7%） ,128 cases （22.9%） of prostatic hyperplasia with low-grade intraepithelial neoplasia （PIN） I ,35 cases （6.3%） of prostatic hyperplasia with high-grade intraepithelial neoplasia （PIN Ⅱ/Ⅲ ） were found. BPH associated with chronic in- flammation were detected in 96 cases （17. 1%）. Alveolar rhabdomyosarcoma was found in 1 case. Complications after prostatic biopsy included gross hematuria in 119 cases （21. 3%）,dysuria, urinary frequency and urgency in 18 cases （3.2%） ,rectal bleeding in 3 cases （0.5%） ,acute urinary retention in 15 cases （2.7%） and fever in 10 cases （1.6%）. No other serious complication was found. CONCLUSION： Transrectal ultrasonography-guided prostate biopsy with 15 sample needle protocol is an ideal approach to diagnose prostate cancer with high accuracy and few complications.