经直肠超声引导5区13针前列腺穿刺活检在前列腺癌筛查中的应用  

Clinical analysis of the use of transrectal ultrasound prostate biopsy in screening of prostate cancer

作　　者：叶炯贤[1] 陈泽波[1] 吴雄辉[1] 胡祎民[1] 李贤新[1] 刘运初[1] 鲁树坤[2] 马雅[3] 关志忱[1] 

机构地区：[1]北京大学深圳医院泌尿外科,广东深圳518036 [2]北京大学深圳医院B超科 [3]北京大学深圳医院病理科

出　　处：《罕少疾病杂志》2007年第6期1-4,共4页Journal of Rare and Uncommon Diseases

基　　金：深圳市卫生科技计划项目;编号:200405154

摘　　要：目的评价经直肠超声引导5区13针前列腺穿刺活检在筛查前列腺癌的临床应用价值。方法对102例患者,年龄49-75岁,平均64.2岁,以前列腺特异性抗原(PSA)4-10ng/ml且游离PSA/总PSA<0.26或PSA10.1-50ng/ml或直肠指诊检查(DRE)异常或B超发现异常回声为穿刺指征,前列腺体积12-109ml,平均49ml,在直肠腔内注入1%盐酸丁卡因凝胶10ml局部粘膜麻醉下行经直肠超声引导5区13针前列腺系统穿刺活检。结果102例患者全部穿刺成功,前列腺癌活检阳性率为23.5%,PSA0-4ng/ml、PSA4.1-10ng/ml、PSA10.1-50ng/ml阳性率分别为9.1%(1/11)、15.4%(6/39)、32.1%(17/53)。前列腺体积<20、20-40ml、40-60ml及>60ml阳性率分别为62.5%(5/8)、27.0%(10/37)、14.3%(7/49)、25.0%(2/8)。术中出现血管迷走神经反应2例,3例直肠大出血,9例术后出现发热,上述患者经相关处理后恢复。结论经直肠超声引导5区13针前列腺穿刺活检术是一种筛查前列腺癌阳性率较高的方法,但在应用中有可能发生一些并发症。术后仔细观察病情变化,预防严重并发症的发生。Objective To evaluate the clinical value of transrectal ultrasound prostate biopsy of 13- core at 5 regions in screening of prostate cancer. Methods The biopsies were performed on 102 patients whose digital rectal examination showed positive results, serum PSA level was abnormal（total PSA level at 10.1-50ng/ml or total PSA level at 4-10ng/ml and fPSA/tPSA（0. 26） or transrectal ultrasound results showed unusual echo. Resykts All of the 102 patients were performed biopsy successfully. 23 of 102 （23. 5%） cases showed prostate cancer, The positive rate of prostate cancer with PSA level at 0-4ng/ml, PSA4, 1-10ng/ml or PSA10.1-50ng/ml was 9.1%（1/11）, 15.4%（6/39）, 32.1%（17/53）, respectively. The positive rate of prostate cancer with prostate volume less than 20 ml, 20-40ml, 40-60ml or more than 60ml was 62.5%（5/8）, 27.0%（10/37）, 14.3%（7/49）, 25.0%（2/8）, respectively. Complications occurred in some patients： Blood vessel-vagus nerve response was found in two cases, 3 cases with proctorrhagia, and 9 cases with fever after biopsy. All the patients with complications recovered after corresponding treatments. Conclusion Transrectal ultrasound prostate biopsy of 13-core at 5 region is a useful method in screening prostate cancer. But it can result in some complications. We can prevent from severe complications by careful care after biopsy.

关 键 词：前列腺肿瘤 活检 超声 

分 类 号：R737.25[医药卫生—肿瘤]