经直肠超声引导下前列腺穿刺活检在前列腺癌筛选中的意义  

Analysis of transrectal ultrasound guided prostatic biopsies

作　　者：伍建业[1] 王建业[1] 刘明[1] 朱生才[1] 张耀光[1] 许进[1] 王宁 

机构地区：[1]卫生部北京医院泌尿外科,100730 [2]辽宁省盘锦市第二人民医院泌尿外科

出　　处：《中华老年医学杂志》2004年第8期546-548,共3页Chinese Journal of Geriatrics

摘　　要：目的　探讨如何进一步选择合适病例进行经直肠超声引导前列腺穿刺活检 ,以提高前列腺癌 (PCa)的诊断 ,并尽量避免不必要的穿刺。　方法　回顾性分析 2 5 8例因怀疑PCa而进行前列腺穿刺活检的患者 ,分析其年龄、前列腺体积、前列腺特异性抗原 (PSA)、经直肠前列腺超声 (TRUS)、核磁共振 (MRI)对于PCa检出率的影响。　结果　 2 5 8例活检结果显示前列腺增生 (BPH) 14 6例 ,PCa 112例。随着患者年龄的增长及PSA的增高 ,PCa的检出率增加 ,而前列腺体积对PCa的检出率无影响。联合使用直肠指诊、PSA、TRUS可以提高PCa的检出率并避免不必要的活检 ,3者皆阳性时检出率为 84 6 %。MRI对PCa诊断的敏感性较高 ,为 98 3% ,但特异性很低 ,为 2 2 4 % ,总有效率为2 1 8%。　结论　应注重直肠指诊、PSA、TRUS在PCa筛选中的作用 ,MRI对于早期PCa的诊断意义有限。Objective To improve the finding of prostate cancer (PCa) and prevent the unnecessary biopsies, we select proper patients for biopsy and analyze. Methods The retrospective study included 258 patients who were biopsied for suspected early PCa. Then we analyse how the age, prostate volume, PSA, transrectal ultrasound sonography (TRUS) and MRI affect the finding of prostate cancer. Results Altogether 146 BPH and 112 prostate cancer by biopsy were detected. Positive ratio of biopsy was increased with the age or PSA increases but has no relationship with the prostate volume. Combination with digital rectal examination, PSA and TRUS, the positive ratio was improved and unecessary biopsies were avoided. The detective rate reached 84.6% when all of these three parameters were positive. The sensitivity of MRI was 98.3% but specificity was only 22.4%. The total efficacy was 21.8%. Conclusions The effect of DRE, PSA and TRUS in the screening of prostate cancer should be emphasized. However, importance of MRI is limited for the early detection of PCa.

关 键 词：经直肠超声引导 前列腺 穿刺活检 前列腺癌 腔内超声检查 磁共振 前列腺特异抗原 肿瘤 

分 类 号：R737.25[医药卫生—肿瘤]