经直肠超声引导下与经会阴途径穿刺活检对前列腺癌的诊断价值比较

Comparison of Diagnostic Value of Ultrasound-Guided Transrectal and Transperineal Puncture Biopsy on Diagnosis of Prostate Cancer

目的:对比经直肠超声引导下经直肠途径与经会阴途径穿刺对前列腺癌的诊断价值。方法:选取2015年6月-2020年6月北京大学首钢医院收治的行前列腺穿刺活检患者427例,其中经直肠穿刺组181例,经会阴穿刺组246例。比较两种途径活检阳性率和并发症发生率。结果:两组前列腺穿刺阳性率比较,差异无统计学意义(P>0.05);按不同前列腺特异性抗原水平、前列腺密度、直肠指诊和直肠超声检查是否异常分层比较,两组检出率差异无统计学意义(P>0.05)。经直肠穿刺组穿刺后发热和血便的发生率高于经会阴穿刺组,但疼痛发生率低于经会阴穿刺组,差异均有统计学意义(P<0.05)。结论:经直肠超声引导下经直肠和经会阴活检对前列腺癌诊断阳性率无显著差异,两种方法穿刺后发热、血便和疼痛的发生率不同,应根据不同患者特点选择不同的穿刺方法。

Objective:To compare the diagnostic value of transrectal ultrasound-guided transrectal and transperineal puncture for prostate cancer.Methods:From June 2015 to June 2020,427 patients who underwent prostate biopsy in Shougang Hospital,Peking University were selected,including 181 cases in the transrectal puncture group and 246 cases in the transperineal puncture group.The positive rate of biopsy and the incidence of complications were compared between the two groups.Results:There was no statistically significant difference in the positive rate of prostate puncture between the two groups(P>0.05).When compared stratified by different prostate specific antigen levels and prostatic densities and whether digital examination and ultrasound examination of rectum were abnormal,there was also no significant difference in the detection rate between the two groups(P>0.05).After puncture,the incidence of fever and bloody stool in the transrectal puncture group was higher than that in the transperineal puncture group,and the incidence of pain was lower than that in the transperineal puncture group,the differences were statistically significant(P<0.05).Conclusion:There is no significant difference in the positive rate of the diagnosis of prostate cancer between ultrasound-guided transrectal and transperineal biopsy.The incidence of fever,bloody stool and pain after the puncture with two methods are different.Different puncture methods should be selected according to the characteristics of different patients.