影响二次经直肠前列腺穿刺活检阳性率的因素分析

To investigate the factors on affectting the positive prostate cancer in the secondary transrectal prostate biopsy

目的 探讨在二次经直肠前列腺穿刺活检中影响阳性率的因素.方法 回顾性分析2008年1月-2014年2月本院55例首次经直肠前列腺穿刺活检阴性并行二次经直肠前列腺穿刺活检的患者临床资料,依第二次穿刺活检结果分为前列腺癌组与非前列腺癌组.比较两组前列腺特异性抗原（PSA）相关参数及首次穿刺时病理结果的差异,并分析影响第二次穿刺活检阳性率的相关因素.结果 前列腺癌组家族史、前列腺特异性抗原速率（PSAV）、前列腺特异性抗原密度（PSAD）水平与非前列腺癌组比较有显著性差异（P＜0.05）;两组首次穿刺活检为高级别前列腺内皮瘤（HGPIN）、非典型小腺泡增生（ASAP）、慢性前列腺炎差异也有统计学意义（P＜0.05）;家族史、PSAV、PSAD、HGPIN、ASAP、穿刺针数为影响二次前列腺穿刺活检阳性率的相关因素.结论 对首次前列腺穿刺活检阴性的患者,结合患者的家族史、首次穿刺活检的病理结果（HGPIN、ASAP）及PSAV、PSAD等参数,可提高二次穿刺活检的肿瘤阳性率,减少不必要的漏诊及不必要的重复穿刺.

Objectives To Explore postive factors on suspicous prostate cancer in the secondary transrectal prostate biopsy.Methods From January 2008-February 2014,55 cases in our hospital had been recevied transrectal secondary prostate biopsy,retrospectively.According to the results of biopsy,the patients were divided into control groups and prostate cancer group.Differences between prostate-specific antigen（PSA） parameters and pathological findings were compared during the first puncture and to analyze the influenced factors in the second biopsy.Results There was significant difference in Family history of prostate cancer,prostate-specific antigen velocity （PSAV）,prostate specific antigen density （PSAD）,HGPIN,ASAP,chronic prostatitis between two groups （P 〈 0.05）.Family history,PSAV,PSAD,HGPIN,ASAP were risk factorsn in secondary needle prostate biopsy.Results There was significant difference in Family history of prostate cancer,prostate-specific antigen velocity （PSAV）,prostate specific antigen density（PSAD）,HGPIN,ASAP,chronic prostatitis between two groups（P 〈 0.05）.Family history,PSAV,PSAD,HGPIN,ASAP were risk factorsn in secondary needle prostate biopsy.Conclusions To avoid misdiagnosis and unnecessary repeat biopies,combined with the patient＆#39;s family history,the first biopsy pathology results （HGPIN,ASAP） and PSAV,PSAD parameters can improve the positive rate of secondary prostate biopsy.