直肠超声引导经会阴途径穿刺活检诊断前列腺癌

The diagnosis of prostate cancer in transperineal biopsy guided by transrectal ultrasound

目的:通过总结经直肠超声(TRUS)引导下经会阴途径前列腺癌(PCa)穿刺活检患者的临床表现、相关检查及病理特征,提高对PCa穿刺活检的病理诊断水平。方法:选择2014年7月至2016年12月期间于我院行TRUS引导下经会阴途径PCa穿刺活检患者101例,对这些患者的临床表现、血清PSA检查、影像学检查及病理检查进行总结。结果:PCa患者年龄多大于60岁,多伴有泌尿系统症状与直肠指检异常、血清PSA常超出上限;影像学表现为病变区域图像改变与血流信号异常;镜检特征主要表现在细胞异型、结构异型和浸润性生长,镜下特征性结构与免疫组化检查有助于PCa的诊断。结论:前列腺穿刺活检病理检查是诊断PCa的金标准,在熟练掌握其病理特征与免疫组化表达的同时,注意结合PCa临床表现与临床相关检查的特点,对提高病理诊断准确性具有重要的临床意义。

Objective： To summarize the clinical manifestations,related examination and pathological features of prostatic carcinoma（ PCa） biopsy guided by transrectal ultrasound（ TRUS）,to improve the pathological diagnosis level of PCa biopsy. Methods： Select the data of 101 patients with transrectal ultrasound guided biopsy of prostate cancer in our hospital from July 2014 to December 2016. The clinical manifestations,serum PSA examination,imaging examination and pathological examination of these patients were summarized. Results： PCa patients ＇ age were usually more than 60 years old,mostly associated with urinary tract symptoms and abnormal rectal examination,and serum PSA often exceeded the upper limit. Imaging findings showed image changes and abnormal blood flow signals in the lesion region. Microscopic features were mainly in the cell dysplasia,structure dysplasia and infiltrative growth,and microscopic features of the structure and immunohistochemical examination were helpful for the diagnosis of PCa. Conclusion：Prostate biopsy pathology examination was the gold standard for the diagnosis of PCa. While mastering its pathological features and immunohistochemical expression,we should pay attention to the combination of clinical manifestations and clinical characteristics of PCa,it had important clinical significance to improve the accuracy of pathological diagnosis.