摘要
目的比较5种不同前列腺穿刺活检方式的前列腺癌检出率和并发症情况。方法收集2001年至2012年间前列腺穿刺活检的住院病例239例，分别采用经会阴6点、手指引导6点、经直肠超声引导6点、5区13针（13点）和6＋4（10点）5种不同穿刺活检方式分组。比较5种前列腺穿刺活检方式的阳性率及并发症情况；同时对比按年龄、直肠指检（DRE）结果、前列腺特异性抗原（PSA）和直肠超声（TRUS）情况分组后的相关结果。结果5种不同穿刺方式组的前列腺癌检出阳性率差异无统计学意义（x^2=6．530，P〉0．05）；5组血尿阳性率的差异有统计学意义（x^2=9．947，P〈0．05），其中5区13针组的血尿阳性率分别高于6＋4组和超声6点组（P〈0．005），手指6点组血尿阳性率高于6＋4组（P=0．005）。按不同年龄和PSA水平分组后，PSA〉20IXg／L组的前列腺癌检出阳性率高于〈10μg／L和10～20μg/L组（P〈0．0125）；〉80岁组的前列腺癌检出阳性率也高于〈70岁组（P〈0．025）；同时DRE阳性和TRUS可疑组的前列腺癌检出阳性率也均高于阴性组（均P〈0．05）。而各分层分组并发症发生情况均无统计学差异（均P〉0．05）。结论对国内临床就诊人群，初次穿刺活检者采用10点的前列腺扩充穿刺即可，部分临床局部进展或前列腺体积较小者，采用6点穿刺足够诊断需要。对未细分穿刺人群简单的统一采用12点以上的穿刺方式不应是最佳选择。
Objective To compare five different systematic prostate biopsies for prostate cancer detection rate and implications. Methods Collecting 239 cases of prostate biopsies from 2001 to 2012, respectively grouped by using 5 different ways as follows： transperineal 6-core biopsy, sextant biopsies under finger guidance, sextant biopsies under transrectal ultrasound （TRUS） guidance, 13-core biopsy scheme, 10-core biopsy scheme. The positive rate and implications were compared in the 5 ways of prostate biopsies, and at the same time compared the related results after grouping by age, digital rectal examination （DRE）, prostate-specific antigen （PSA） and TRUS. Results It was not statistically significant of positive detection rate of prostate cancer in 5 different groups of prostate biopsies （x^2 = 6. 530, P 〉 0.05 ）, while the overall difference of the positive rate of hematuria in the 5 groups was statistically significant （X^2 = 9. 947, P 〈 0.05 ）. The positive rate of hematuria of 13-core biopsy scheme was higher than 10-core biopsy scheme and sextant biopsies under transrectal ultrasound （TRUS） guidance group （P 〈 0. 005 ）, and the positive rate of hematuria of sextant biopsies under finger guidance was also higher than 10-core biopsy scheme group （P = 0. 005 ）. Grouped according to the different age and the level of PSA, the positive rate of prostate cancer in the group of PSA 〉 20 μg/L was higher than that of PSA 〈 10 μg/L and 10 - 20 μg/L （P 〈 0. 012 5 ）, while the positive rate of prostate cancer in the group of more than 80 years old was also higher than that of less than 70 years old group （P 〈 0. 025 ）. At the same time, the positive rate of prostate cancer in both abnormal DRE findings and TRUS suspected group was also higher than that in the negative group （ P 〈 0.05 ）, but the incidence of implication had no statistical difference. Conclusions The majority of initial prostatic biopsy can only use 10-core extended prostatic biopsy, while simple sextant biopsies might be sufficient to obtain tissue confirmation for diagnosis of obvious locally advanced or small prostate volume. It is not the best choice to adopt more than 12-core biopsy scheme on patients who haven＇t been subdivided.
出处
《中国肿瘤外科杂志》
CAS
2014年第3期141-145,共5页
Chinese Journal of Surgical Oncology
关键词
前列腺癌
前列腺穿刺活检
穿刺方法
阳性检出率
prostate cancer
prostate biopsy
puncturing method
positive detection rate
