摘要
目的:探讨超声引导下经会阴前列腺24针饱和穿刺活检与14针穿刺活检方案对PSA<20μg/L可疑前列腺癌患者的筛检阳性率及其相关并发症。方法:选取116例可疑前列腺癌患者行经会阴超声引导下14针穿刺活检(14针组),另136例患者,行经会阴24针饱和前列腺穿刺活检(24针饱和组),比较两组前列腺癌筛检阳性率、标本阳性率及穿刺后肉眼血尿、泌尿系感染、尿潴留等并发症的发生率。结果:两组患者平均年龄、穿刺前PSA水平、平均前列腺体积等指标均无统计学差异(P>0.05)。24针饱和组及14针组前列腺癌筛检总体阳性率分别为48.53%和17.24%,存在显著性差异(P<0.001),标本阳性率分别为8.09%和2.83%(P=0.012);其中24针饱和组前列腺尖部肿瘤的检出率(11.76%)显著高于14针组(1.72%,P<0.05)。两组穿刺后尿潴留、泌尿系感染和肉眼血尿等发生率均无统计学差异(P>0.05)。结论:24针经会阴前列腺饱和穿刺活检方法显著提高PSA<20μg/L患者中前列腺癌的筛检阳性率,尤其是增加了前列腺尖部区域的肿瘤筛检阳性率,而并未增加相关并发症。
Objective： To compare the detection rates of prostate cancer（PCa） and complications of the transrectal ultrasonography（TRUS）-guided 24-core saturation scheme versus 14-core scheme for transperineal prostate biopsy in patients with total PSA 20 μg/L.Methods： We performed TRUS-guided 24-core saturation transperineal biopsy for 136 patients suspected of PCa（24-core group） and 14-core biopsy for another 116（14-core group）.We compared the PCa detection rates and post-biopsy complications,such as gross hematuria,urinary system infection,and acute urinary retention between the two groups.Results： The baseline characteristics of the two groups were comparable with regard to the mean age,prostate volume and PSA level（P 0.05）.The positive rates of PCa detection were 48.53%（66/136） in the 24-core group and 17.24%（20/116） in the 14-core group（P 0.001）,and the positive rates of samples were 8.09% and 2.83%,respectively（P = 0.012）.The detection rate of PCa in the apex zone was significantly higher in the former（11.76%） than in the latter（1.72%）（P 0.05）.There were no statistically significant differences in such post-biopsy complications as gross hematuria,urinary system infection,and acute urinary retention between the two groups（P 0.05）.Conclusion： TRUS-guided 24-core saturation transperineal biopsy of the prostate is superior to the 14-core scheme for its higher detection rate of PCa,particularly PCa in the apex zone,and lower incidence of complications in patients with PSA 20 μg/L.
出处
《中华男科学杂志》
CAS
CSCD
2012年第4期306-309,共4页
National Journal of Andrology
关键词
前列腺癌
筛检
穿刺活检
饱和前列腺穿刺
prostate cancer
screen
needle biopsy
prostate saturation biopsy
