直肠超声引导下经会阴与经直肠前列腺穿刺活检术临床价值比较

Comparison of clinical value between transperineal and transrectal prostate puncture biopsy guided by rectal ultrasound

目的比较直肠超声引导下经会阴与经直肠前列腺穿刺活检术的临床应用价值。方法选择2016年3月至2018年3月德阳市人民医院收治的117例疑似前列腺癌患者为研究对象,所有患者行直肠超声引导下经会阴与经直肠前列腺穿刺活检术,以病理学检查结果为标准,比较直肠超声引导下经会阴前列腺穿刺活检术与直肠超声引导下经直肠前列腺穿刺活检术在前列腺癌诊断中的应用价值。结果117例疑似前列腺癌中,最终病理检查阳性60例,阴性57例。经会阴前列腺穿刺活检阳性45例,阴性72例;经会阴前列腺穿刺活检诊断前列腺癌的灵敏度、特异度、准确度分别为61.67%(37/60)、85.96%(49/57)、73.50%(86/117),阳性预测值和阴性预测值分别为82.22%(37/45)、68.06%(49/72)。经直肠前列腺穿刺活检阳性48例,阴性69例;经直肠前列腺穿刺活检诊断前列腺癌的灵敏度、特异度、准确度分别为60.00%(36/60)、78.95%(45/57)、69.23%(81/117),阳性预测值和阴性预测值分别为75.00%(36/48)、65.22%(45/69)。2种穿刺活检诊断前列腺癌的灵敏度、特异度、准确度、阳性预测值、阴性预测值比较差异均无统计学意义(P>0.05)。结论直肠超声引导下经会阴与经直肠前列腺穿刺活检术在前列腺癌诊断中均具有良好的应用价值,2种方法对前列腺癌的诊断效能无显著差异,可依据患者具体情况选择合适的穿刺方法。

Objective To compare the clinical value between transperineal and transrectal prostate puncture biopsy guided by rectal ultrasound.Methods A total of 117 patients with suspected prostate cancer admitted to Deyang People′s Hospital from March 2016 to March 2018 were selected as the research objects.All patients underwent transperineal and transrectal prostate puncture biopsy guided by rectal ultrasound.Based on the results of pathological examination,the diagnostic value of transperineal and transrectal prostate puncture biopsy guided by rectal ultrasound for prostate cancer was compared.Results Among the 117 cases of suspected prostate cancer,60 cases were positive and 57 cases were negative.The results of transperineal prostate puncture biopsy were positive in 45 cases and negative in 72 cases.The sensitivity,specificity and accuracy of transperineal prostate puncture biopsy in the diagnosis of prostate cancer were 61.67%(37/60),85.96%(49/57)and 73.50%(86/117),respectively;and the positive predictive value and negative predictive value were 82.22%(37/45)and 68.06%(49/72),respectively.The results of transrectal prostate puncture biopsy were positive in 48 cases and negative in 69 cases.The sensitivity,specificity and accuracy of transrectal prostate puncture biopsy in the diagnosis of prostate cancer were 60.00%(36/60),78.95%(45/57)and 69.23%(81/117),respectively;and the positive predictive value and negative predictive value were 75.00%(36/48)and 65.22%(45/69),respectively.There was no significant difference in the sensitivity,specificity,accuracy,positive predictive value and negative predictive value between the two methods in diagnosing prostate cancer(P>0.05).Conclusion The transperineal and transrectal prostate puncture biopsy guided by rectal ultrasound have good application value in the diagnosis of prostate cancer.The diagnostic efficacy for prostate cancer of the two methods was similar.The appropriate puncture method can be selected according to the specific situation of patients.