经直肠超声引导下6针及10+x针穿刺活检术对前列腺癌诊断价值的对比分析

Comparative analysis of the value of 6 cores and 10+x cores ultrasound-guided transrectal prostatic biopsy in the diagnosis of prostate cancer

目的比较经直肠超声引导下6针及10+x(x为若干针,且<10)针穿刺活检术对前列腺癌诊断价值。方法检索PubMed、Embase、Web of science、SCI、中国生物医学文献数据库、万方医学、中国知网、维普数据库等数据库,检索时间范围为2009—2019年。根据纳入与排除标准,筛选文献、提取资料,并进行文献质量评价。对纳入的文献采用Review Manager 5.3软件进行统计学分析。结果共纳入16篇文献,包括1篇随机对照研究,15篇病例对照研究。其中5篇研究为组间对照,组间对照共纳入674例患者,其中6针组320例,10+x针组354例;另有11篇研究为组内自身对照,共纳入3730例患者。meta分析显示,经直肠超声引导下6针组的前列腺癌检出率低于10+x针组[OR=0.53,95%CI:0.37~0.74,P=0.0002(组间对照);OR=1.44,95%CI:1.30~1.59,P<0.00001(组内自身对照)];两组并发症发生率比较,差异无统计学意义(OR=0.60,95%CI:0.26~1.36,P=0.22)。结论经直肠超声引导下10+x针法穿刺活检术对前列腺癌的检出率较高,值得临床推广应用。

Objective To compare the diagnostic value of ultrasound-guided transretal prostatic biopsy with 6 cores and 10+x(x is several cores,and<10)cores in the diagnosis of prostate cancer.Methods Databases including PubMed,Embase,Web of science,SCI,China Biomedical Literature Database,CNKI,WanFang Database and VIP Database were searched from 2009 to 2019.According to the established inclusion and discharge criteria,the relevant literature was searched,and the documents that meet the standards were selected as the final included literature and extracted data and assessed the risk of bias of eligible studies.The included literatures were statistically analyzed using Review Manager 5.3 software.Results A total of 16 literatures were included,including 1 randomized controlled study and 15 case-control studies.Among them,5 studies were intergroup controls.A total of 674 patients were included in the intergroup controls,including 320 patients in the 6 cores group and 354 patients in the 10+x cores group.And another 11 studies were self-control which consists of 3730 patients.Meta-analysis showed that the detection rate of prostate cancer in the 6 cores group guided by transrectal ultrasound prostatic biopsy was lower than that in the 10+x cores group(OR=0.53,95%CI:0.37~0.74,P=0.0002[inter group control],OR=1.44,95%CI:1.30~1.59,P<0.00001[intragroup self control]).There was no significant difference in the incidence of complications between the two groups(OR=0.60,95%CI:0.26~1.36,P=0.22).Conclusion Ultrasound-guided transretal prostatic biopsy with 10+x cores has a high detection rate for prostate cancer,which is worthy of clinical application.