实时超声引导经会阴/直肠前列腺系统精准活检在前列腺癌诊断中的应用价值

The Application Value of Real-time Ultrasound-guided Precise Biopsy of Prostate Through Perineum/Rectum in the Diagnosis of Prostate Cancer

为探讨实时超声引导经会阴/直肠前列腺系统精准活检在前列腺癌诊断中的应用价值,本研究回顾性分析2016年1月~2018年12月于我院接受前列腺穿刺活检的150例疑似前列腺癌患者的完整临床资料,将行实时超声引导经会阴前列腺活检的74例患者纳入A组,其中前列腺特异性抗原(PSA)灰区患者26例;将行实时超声引导经直肠前列腺系统精准活检的76例患者纳入B组,其中PSA灰区患者28例,比较各组患者一般资料、前列腺癌检出率、PSA灰区前列腺癌检出率,以及术后并发症情况。结果显示,两组年龄、PSA水平、前列腺体积比较,差异无统计学意义(P>0.05);A组穿刺针数及手术时间均高于B组(P<0.05);A组PSA灰区患者前列腺癌检出率高于B组(P<0.05);A组血便发生率低于B组(P<0.05)。实时超声引导经会阴与经直肠前列腺系统精准活检在前列腺癌诊断中的检出率相当,但针对PSA灰区患者而言,经会阴穿刺活检的检出率更高,且术后血便等并发症发生率低,安全性更高。

To investigate the application value of real-time ultrasound-guided transperineal/rectum prostate precise biopsy in the diagnosis of prostatic cancer,the clinical complete data of 150 patients with suspected prostatic cancer who underwent prostate needle biopsy from January 2016 to December 2018 were retrospectively analyzed in this study.74 patients with real-time ultrasound-guided transperineal prostate biopsy were included in A group,including 26 cases of patients with prostate-specific antigen(PSA)gray zone;And 76 patients with real-time ultrasound-guided transrectal needle biopsy were included in B group,including 28 cases of patients with PSA gray zone.The general data,detection rate of prostatic cancer,detection rate of prostatic cancer in PSA gray zone,postoperative complications in two groups were observed.The results showed that,there was no statistically significant defference in age,PSA level and prostate volume between the two groups(P>0.05);the number of needling and operation time in A group were higher than those in B group(P<0.05);The detection rate of prostatic cancer in PSA gray zone in A group was higher than that in B group(P<0.05);The incidence of bloody stool in A group was lower than that in B group(P<0.05).Therefore,real-time ultrasound-guided transperineal and transrectal needle biopsy in diagnosis of prostatic cancer have similar detection rate.However,as for patients with PSA gray zone,the detection rate of transperineal needle biopsy is higher,the incidence of postoperative bloody stool was lower,and the safety is higher.