摘要
目的探讨经直肠超声引导移行区穿刺在前列腺癌检测中的作用。方法1956例因前列腺特异性抗原（PSA）升高或直肠指检异常拟行前列腺穿刺活检的患者，所有患者穿刺采用系统穿刺法加移行区穿刺方案，并根据PSA、直肠指检、经直肠超声、前列腺体积及PSA密度（PSAD）对所有患者进行分组，比较分析移行区穿刺对提高各组患者穿刺阳性率的作用。结果1956例患者经穿刺病理诊断为前列腺癌762例（762／1956，39．0％），采用系统穿刺法加移行区穿刺比单独采用系统穿刺法多发现86例前列腺癌（P=0．004）。在PSA〉10ng／ml、直肠指检阴性、经直肠超声阴性、前列腺体积≥30ml及PSAD≥0．18的病人中，增加移行区穿刺点其前列腺癌穿刺阳性率分别提高了5．8％、5．5％、6．8％、4．3％及5．8％（P〈0．05）。结论增加移行区穿刺可提高前列腺癌的检出率。
Objective To determine the utility of routine transition zone biopsies in men undergoing transrectal ultrasound-guided transperineal prostate biopsies. Methods A total of 1956 consecutive patients underwent transrectal ultrasound-guided prostate biopsies for the first time. Systematic biopsies and additional 2 cores transition zone biopsies were performed. The patients were classified to different subgroups according to prostate-specific antigen （PSA）, digital rectal examination （DRE） results, transrectal ultrasonography （TRUS） results, prostate volume and PSA density （PSAD）. The impact of transition zone biopsies on the prostate cancer detection rate of different groups of patients was analyzed. Results Prostate cancer was detected in 762（39.0%）of the 1956 patients, and 86 of these patients had positive cores only in TZ （P=0.004）. The increase in the cancer detection rate by two-core TZ biopsies was 5.8%, 5.5%, 6.8%, 4.3% and 5.8% respectively in patients with PSA level above 10 ng/ml, negative DRE findings, negative TRUS findings, prostate volume over 30ml and PSAD above 0.18 （P〈0.05）. Conclusion Routine transition zone biopsies may improve the detection rate of prostate cancer in transperineal biopsy protocol.
出处
《中国男科学杂志》
CAS
CSCD
北大核心
2012年第11期28-32,共5页
Chinese Journal of Andrology
基金
国家自然科学基金面上项目（81271595）
上海市科委项目（10JC1411400
10411952000
09411963800）
上海交通大学医学院科技基金项目（11XJ21019）
