经直肠超声引导13点前列腺穿刺活检在前列腺癌诊断中的应用

Application of transrectal ultrasound-guided 13-core prostate biopsy in diagnosis of prostate cancer

目的探讨经直肠超声引导5区13点前列腺穿刺活检在诊断前列腺癌的应用价值。方法拟诊前列腺癌患者139例,行经直肠超声引导13点前列腺穿刺(13点组)活检,结果与10点穿刺法(不包括前列腺中线尖部、中部和底部3点)(10点组)比较,分析前列腺癌检出率与血清前列腺特异抗原(PSA)水平和前列腺体积的关系。结果两组前列腺癌总检出率相仿(52.52%vs.49.64%)(P>0.05)。两组前列腺癌检出率随着血清PSA水平升高而增加,随着前列腺体积增大而降低(P<0.05)。结论与10点法比较,经直肠超声引导下13点穿刺并没有明显提高前列腺癌检出率;对于小体积的前列腺,10点穿刺术可作为临床首选。

Objective To investigate the clinic value of transretal ultrasound‐guided 13‐core prostate biopsy in the detection of prostate cancer .Methods The transretal ultrasound‐guided 13‐core prostate biopsy（group 13‐core） was performed in 139 patients with a suspected diagnosis of prostate cancer .The results were compared to those from 10‐core prostate biopsy （group 10‐core） ,in which three middle cores at apex ,middle and base of the central zone were excluded .The relationship of the prostate cancer detection rate with serum levels of prostate specific antigen（PSA） and prostate size was analyzed .Results The overall positive rate of prostate cancer of group 13‐core was similar to that of group 10‐core（52.52% vs .49.64% ）（P〉0 .05） .The detection rate of prostate cancer of two groups was increased as serum levels of PSA elevated ,but decreased as the volume of prostate enlarged（P〈0 .05） .Conclusion Compared with 10‐core biopsy ,13‐core biopsy does not obviously increase the detection rate of prostate cancer .The 10‐core biopsy should be taken as the first choice for the diagnosis of prostate cancer in the patients with relatively smaller prostate .