超声引导下徒手经会阴与经直肠活检诊断前列腺癌的倾向性评分匹配研究

Comparison of the clinical diagnostic efficacy between free-hand transperineal prostate biopsy and transrectal prostate biopsy

目的:比较超声引导下徒手经会阴和经直肠穿刺活检对前列腺癌的诊断价值。方法:收集2013年7月~2019年7月间568例接受经直肠或徒手经会阴前列腺活检患者的临床资料,进行回顾性和倾向评分匹配(PSM)分析。结果:其中139例徒手经会阴途径,429例经直肠途径,2组病例设置Caliper值为0.01进行1∶1样本匹配。倾向评分匹配后,徒手经会阴活检组的癌症检出率显著高于经直肠活检组(49.6%vs 36.7%,P=0.029);匹配后2组间GS≤6癌检出率无显著差异(49.3%vs 41.2%,P=0.379);癌症检出率与PSA水平和前列腺体积显著相关。结论:徒手经会阴穿刺活检与经直肠活检相比,有较高的癌症检出率。

Objective:To compare the clinical diagnostic value of the free-hand transperineal prostate biopsy(TPBx)versus transrectal prostate biopsy(TRBx) in the detection of prostate cancer(PCa).Methods:A retrospective and propensity score matched(PSM)analysis was conducted on clinical data of 568 patients who received either transrectal or free-hand transperineal prostate biopsy which all performed by a urologist from July 2013to July 2019.Among these 568 men,139 patients experienced free-hand TPBx,while 429 patients TRBx.TRBx and TPBx patients were matched 1:1 as samples with a caliper value of 0.01.Results:Propensity score-matching analysis showed that the detection rate of free-hand TPBx was higher than that of TRBx significantly(49.6% vs 36.7%,P=0.029).There was no significant difference on GS≤6 cancers detection between the two groups after matching(49.3% vs 41.2%,P=0.379).The detection rate of prostate cancer was significantly associated with PSA level and prostate volume.Conclusion:Free-hand transperineal biopsy(TPBx)is an effective method for prostate biopsy,and it has the higher cancer detection rate when comparing to TRBx.