不同PSA水平的国人首次前列腺穿刺活检所需穿刺针数的研究  

Comparison of Puncture Methods for Transrectal Ultrasound-guided Prostate Biopsy at Various PSA Levels

作　　者：徐叶青[1] 郭剑明[1] 朱延军[1] 杨念钦[1] 王一惟[1] 王国民[1] 

机构地区：[1]复旦大学附属中山医院泌尿外科,上海200032

出　　处：《肿瘤防治研究》2014年第2期124-127,共4页Cancer Research on Prevention and Treatment

摘　　要：目的比较不同PSA水平患者采用6点法和12点法的前列腺活检阳性率,探讨针对不同的患者人群设计国人合理的首次前列腺穿刺点数。方法通过研究首次接受直肠超声引导经会阴前列腺穿刺的425例患者,在PSA的不同水平段,比较6点法和12点法的阳性率的差异,以及阳性患者穿刺活检Gleason评分与前列腺癌根治术后病理标本Gleason评分之间的差异。结果 425例患者中6点法穿刺224例,12点法201例。PSA】20 ng/ml的患者6点法与12点法的阳性率分别为85.3%、77.5%(P】0.05);PSA10~20 ng/ml患者6点法和12点法的阳性率分别为33.8%、39.1%(P】0.05)。两者的12点法比6点法没有更高的阳性率。PSA≤10 ng/ml患者6点法和12点法的阳性率分别为24.1%、45.8%(P【0.05),12点法比6点法阳性率显著提高。结论对于国人首次行前列腺穿刺,若PSA】20 ng/ml推荐行6点法穿刺;PSA≤10 ng/ml推荐12点法穿刺,而PSA在10~20 ng/ml则两种穿刺方法均可以选用。Objective To study whether patients benefit more from the 12-point method than the 6-point method in prostate biopsy, and recommend suitable point method for treatment. Methods The first time transrectal ultrasound-guided prostate biopsy was performed in 425 cases, among which 224 cases underwent the 6-point puncture method and the other 201 cases underwent the 12-point puncture method. In this study we compared the positive rate of different methods at various PSA levels and the variation of Gleason score before and after surgery. Results In patients with PSA>20ng/ml, the positive rate of 6- and 12-point method were 85.3% and 77.5%(P>0.05) respectively. In patients with 10ng/ml<PSA≤20 ng/ml, the positive rate of 6- and 12-point method were 33.8% and 39.1%(P>0.05). The 12-point method didn't bring a higher positive rate than the 6-point method. In the group of PSA≤10 ng/ml, the positive rate of 6- and 12-point method was 24.1% and 45.8%, respectively(P<0.05). The 12-point method brought a statistically higher positive rate than the 6-point method. Conclusion For patients with PSA>20 ng/ml, 6-point method is suffi cient for diagnosis and treatment guidance. For patients with PSA≤10 ng/ml, 12-point method is recommended. For patients with 10≤PSA<20 ng/ml, both 6- and 12-point methods are applicable.

关 键 词：前列腺癌 前列腺穿刺活检术 前列腺特异抗原 GLEASON评分 

分 类 号：R737.25[医药卫生—肿瘤]