摘要
目的探讨在初次前列腺穿刺活检阴性人群中应用5α还原酶抑制剂非那雄胺,对再次前列腺穿刺活检结果的影响。方法选取42例经初次前列腺穿刺活检为阴性结果且血清前列腺特异性抗原(PSA)水平仍持续增高的患者为研究对象。口服非那雄胺12个月后进行二次直肠超声引导下经会阴前列腺饱和穿刺活检。按照PSA下降程度及前列腺体积缩小程度,分析各组前列腺癌检出率及肿瘤Gleason评分情况。结果所有患者口服非那雄胺12个月后均有不同程度的PSA下降及前列腺体积的缩小。经二次活检,11例(26.19%)诊断为前列腺癌。其中PSA下降<40%者再次穿刺前列腺癌阳性率显著高于PSA下降百分比>40%组(35.71%vs.21.43%,P=0.023)。依据前列腺体积缩小比率分析,二次穿刺前前列腺体积缩小<20%组前列腺癌阳性率明显高于>20%组(31.25%vs.23.08%,P=0.039)。各组间前列腺癌Gleason评分分布情况无统计学差异(P>0.05)。结论对于首次前列腺穿刺活检阴性而PSA的水平仍持续增高的患者,非那雄胺可提高二次前列腺穿刺活检的阳性率,而高级别前列腺癌的检出率并未增加。
Objective To investigate the effect of finasteride in re- biopsy of the prostate in patients with previous negative biopsy.Methods A total of 42 patients with abnormal PSA value after a negative biopsy of the prostate were included. Re- biopsy with ultrasound-guided transrectal saturation biopsy of the prostate was performed after finasteride therapy for 12- months. Results of re- biopsy were analyzed including prostate cancer positive rate and Gleason score according to the PSA decrease rate and prostate volume decrease rate. Results All patients had relatively decreased PSA value and prostate volume after finasteride therapy for 12- mon and 11 /42（ 26. 19%） patients were proved as positive. The rate of prostate cancer was higher in patients whose PSA decreased less than 40% compared with those whose PSA decreased more than40%（ 35. 71% vs. 21. 43%,P = 0. 023）. And the rate of prostate cancer was higher in patients whose prostate volume decreased less than 20%compared with those whose prostate volume decreased more than 40%（ 31. 25% vs. 23. 08%,P = 0. 039）. There was no pathologic difference between each groups. Conclusion Finasteride increases the sensitivity of re- biopsy in patients with negative biopsy of the prostate without effect on pathologic characteristic.
出处
《临床和实验医学杂志》
2015年第20期1714-1716,共3页
Journal of Clinical and Experimental Medicine
关键词
前列腺癌
穿刺活检
非那雄胺
Prostate cancer
Saturation biopsy
Finasteride
