经直肠B超引导下前列腺穿刺活检在前列腺癌诊断中的应用价值(附658例报告)  

Comprehension of prostate puncture biopsy by transrectal ultrasound (Report of 658 cases)

作　　者：范海涛[1] 王尧[2] 王凯臣[2] 王伟华[2] 计国义[2] 高洪文[2] 潘淑琴[2] 孔祥波[2] 赵学俭[2] 桑原正明 

机构地区：[1]吉林大学第二医院泌尿外科,长春130041 [2]吉林大学前列腺疾病防治研究中心 [3]日本国宫城县癌中心

出　　处：《临床泌尿外科杂志》2007年第6期435-437,共3页Journal of Clinical Urology

基　　金：中日政府间专项技术合作项目第59项(JICA援助项目)

摘　　要：目的:探讨经直肠超声引导下穿刺活检在前列腺癌(PCa)诊断中的临床应用价值。方法:自2000年开始,对中老年男性进行以PSA为主要检查指标的PCa普查,累计23761例。普查中发现PSA>4μg/L者占普查人群的8.0%,达1900例。以前列腺PSA密度(PSAD)>0.15ng/cm3,同时结合直肠指诊为658例疑似PCa者行经直肠超声引导下的前列腺外腺6点穿刺活检术。结果:经穿刺证实为PCa者168例(25.5%),BPH者347例(52.7%),非典型性增生者24例(3.6%),腺瘤样改变者36例(5.5%),前列腺炎者57例(8.7%),肉芽肿性前列腺炎者26例(4.0%);168例PCa者中,前列腺周围区见低回声反射103例(61.3%)。PCa者PSAD为0.19±0.04,前列腺体积为(28.11±12.79)cm3;BPH者PSAD为0.12±0.02,前列腺体积为(36.22±18.18)cm3,分别比较差异有统计学意义(P<0.01)。结论:经直肠超声引导下前列腺6点穿刺活检具有准确、安全等优点,是确诊PCa的有效方法之一。同时结合正确应用PSA、PSAD,不但提高PCa的早期诊断率,而且有助于PCa高危人群的随访。Objective：To discuss clinical use of prostate puncture biopsy by transrectal ultrasound in diagnosis of prostatic carcinoma. Methods： Prostate specific antigen（PSA） was used as the major examination index of general investigation of prostatic carcimoma（PCa）. There were 1 900 cases whose PSA were higher than 4μg/L. PSA density（PSAD） ,which was higher than 0.15 ng/cm^3 , and digital rectal examination（DRE） were also used as index. 658 cases who were suspected to be PCa underwent 6-point puncture bioPsy of external gland of prostate by transrectal ultrasound （TRUS）. Results： 168 cases（25.5 % ） were PCa. 347 cases（ 52.7 % ） were benign prostate hyperplasia（BPH）. 24 eases（3.6 % ） were prostatic intraepithelial neoplasia （PIN）. 36 cases（5.5% ） seemed like adenoid tumor. 57 eases（8.7%） were prostatitis. 26 eases（4.0%） were Granulomatous prostatitis. There was low resonance reflection of peripheral zone in 103 cases of PCa（61.3%）. PSAD and prostatic size of PCa group were （0.19±0.04） and （28.11±12.79） cm^3. PSAD and prostatic size of BPH group were （0. 12±0. 02） and （36.22± 18.18） cm^3. Difference was very significantly（P〈0.01 ）. Conclusions：6-point puncture biopsy by transreetal ultrasound was accurate and safe. It was the most effective method in diagnosis of PCa. If it was combined with correct PSA and PSAD,early diagnosis rate of PCa would increase. And the follow-up of high risk group would be easy.

关 键 词：前列腺癌 经直肠超声 穿刺活检 前列腺特异抗原 

分 类 号：R737.25[医药卫生—肿瘤]