前列腺系统穿刺不同分区组织条质量的研究

Study of the systemic biopsy tissue quality in different prostate region

目的探讨前列腺系统穿刺活检中不同区域组织条质量的差异。方法回顾性分析2013年5月至2020年12月于苏北人民医院接受经会阴前列腺系统穿刺的806例患者的临床资料。患者中位年龄72(66,77)岁,中位前列腺特异性抗原(PSA)18.4(10.3,34.2)ng/ml,前列腺体积43(32,56)ml。组织条破碎程度评分标准:1分,为多个碎片,碎片组织条长度≤5 mm;2分,至少有一条长度>5 mm且≤10 mm的碎片组织条;3分,至少有1条碎片组织条长度>10 mm。记录前列腺不同分区组织条破碎程度评分及组织条长度,并比较其差异。结果806例患者共取组织条8866条,总体组织条中位长度1.2(1.0,1.5)cm。根据组织条破碎程度评分标准,618条(7.0%)为1分,2720条(30.7%)为2分,5528条(62.4%)为3分。尖部组织1分占11.7%(94/806),2分占34.7%(280/806),3分占53.6%(432/806);基底部1分占6.5%(524/8060),2分占30.3%(2440/8060),3分占63.2%(5096/8060),尖部组织破碎程度与基底部差异有统计学意义(H=35.850,P<0.05);前列腺尖部组织条中位长度1.0(0.8,1.3)cm,基底部组织条长度1.2(1.0,1.5)cm,尖部组织条长度短于基底部(Z=-11.353,P<0.05)。结论在经会阴前列腺系统穿刺中,尖部较基底部具有较多的破碎组织和较短的前列腺组织条,应重点关注该区域的穿刺。

Objective To explore the quality differences of systemic biopsy specimens from different regions in prostate biopsy.Methods The data of 806 patients who underwent transperineal prostate biopsy from May 2013 to December 2020 in Northern Jiangsu People’s Hospital were retrospectively reviewed.The median age of the patients was 72(66,77)years old,median PSA was 18.4(10.3,34.2)ng/ml,and prostate volume was 43(32,56)ml.Tissue quality were graded from low to high as follows.One score means multiple fragments with fragmented tissue≤5 mm.Two scores means at least one fragment>5 mm and≤10 mm.Three scores means at least one fragment>10 mm.The prostate specimens fragmentation scores and the length of the specimens in different regions of the prostate were collected to analyze.Results A total of 806 patients were included in our study.The number of tissues was 8866,and the mean length of tissues was 1.2(1.0,1.5)cm.The tissues of different region were scored according to the scoring criteria,of which 618(7.0%)prostate tissues were scored as 1 score,2720(30.7%)tissues were scored as 2 scores,and 5528(62.4%)tissues were scored as 3 scores.In the prostate apex,tissue quality of 1 score accounted for 11.7%(94/806),2 scores accounted for 34.7%(280/806),and 3 scores accounted for 53.6%(432/806).While in the prostate base,tissue quality of 1 score accounted for 6.5%(524/8060),2 scores accounted for 30.3%(2449/8060),and 3 scores accounted for 63.2%(5096/8060)(H=35.850,P<0.05).The mean length of the prostate apical tissue was 1.0(0.8,1.3)cm,which was significantly shorter than prostate basal tissue of 1.2(1.0,1.5)cm(Z=-11.353,P<0.05).Conclusions In transperineal prostate biopsy,the apical tissue was more fragmented and shorter,prostate apex should be concerned.