摘要
目的前列腺穿刺活组织检查是确诊前列腺癌的"金标准",然而其提示肿瘤一侧性的临床意义目前研究相对较少。文中比较前列腺穿刺活组织检查标本与根治性切除标本的肿瘤一侧性分布情况,并进一步分析其与根治性切除术后切缘阳性(positive surgical margin,PSM)的相关性。方法通过回顾性研究在我院160例经B超下前列腺穿刺活组织检查证实并接受根治性切除手术的前列腺癌患者,比较穿刺活组织检查标本与根治性切除术标本的肿瘤分布情况是否一致,并分析穿刺活组织检查标本中肿瘤一侧性与手术PSM的相关性。结果穿刺活组织检查提示肿瘤双侧均有分布的患者共65例,且根治切除标本见双侧叶占位;而穿刺活组织检查提示肿瘤单侧分布的患者共95例,其中根治切除术标本提示双侧均有占位54例(56.8%),单侧分布的穿刺活组织检查标本与根治切除标本的差异有统计学意义(P<0.001)。对于手术切缘阳性率,前列腺穿刺活组织检查标本肿瘤单侧分布组与双侧分布组的比较,差异有统计学意义(χ2=17.621,P<0.001)。结论穿刺活组织检查标本中的肿瘤单侧分布不可预测根治切除标本肿瘤为单侧分布,而穿刺活组织检查标本中的肿瘤双侧分布对手术PSM的影响有意义,宜结合其他临床相关参数进一步评估手术PSM。
Objective Prostate biopsy has become the gold standard method for the diagnosis of prostate cancers. Besides, it could supply the laterality of prostate cancer which gets relatively little research on. This study was to compare tumor laterality in both needle biopsy and radical prostatectomy specimen, and to study the correlation between tumor laterality and positive surgical margin. Methods The retrospective study recruited 160 patients with prostate cancer who had been diagnosed by transrectal ultrasound （TRUS）-guided prostate biopsy,and eventually treated with radical prostatectomy at our hospital, in order to compare tumor distribu- tion in both needle biopsy and radical prostatectomy specimen, and access the impact of tumor laterality in needle biopsy on positive sur- gical margin. Results All 65 patients with bilateral tumors on needle biopsy had bilateral tumors on final pathology. However, of the 95 patients with unilateral tumors on biopsy, 54 （56.8%）had bilateral tumor on final pathology. The unilateral positive biopsy were significantly different from final pathology（ P 〈 0.001 ）. For positive surgical margin rate, there was significant difference between uni- lateral distribution and bilateral distribution groups in needle biopsy（ X2 = 17. 621 ,P 〈 0.001 ）. Conclusion The unilateral positive biopsy does not predict unilateral tumor in final pathology. The bilateral tumor distribution in biopsy has a significant impact on positivesurgical margin. It should be combined with other concerning clinical parameters to further evaluate the positive surgical margin.
出处
《医学研究生学报》
CAS
北大核心
2013年第4期360-362,共3页
Journal of Medical Postgraduates
基金
国家青年科学基金(81000247)
关键词
前列腺癌
穿刺活组织检查
根治切除病理
肿瘤一侧性
切缘阳性
Prostate cancer
Needle biopsy
Radical pros-tateetomy specimen
Tumor laterality
Positivesurgical margin
