超声引导下前列腺结节活检对提高前列腺癌诊断率的研究  

Diagnostic Value of Lesion-Directed Prostate Biopsy Under TRUS in Early Detection of Prostate Cancer

作　　者：朱江[1] 刘学明[1] 杜传军[2] 张哲伟[2] 裘益青[2] 龚宇[2] 刘精锐[1] 洪玉荣[1] 罗志艳[1] 张勇[2] 

机构地区：[1]浙江大学医学院附属第二医院超声科,浙江杭州310009 [2]浙江大学医学院附属第二医院泌尿外科,浙江杭州310009

出　　处：《中华男科学杂志》2009年第5期437-440,共4页National Journal of Andrology

摘　　要：目的:通过前列腺内各种回声结节的穿刺病理结果,探讨前列腺内异常回声结节的病理诊断与鉴别诊断对提高早期前列腺癌诊断率的意义。方法:对95例临床疑前列腺癌患者行经直肠超声(TRUS)引导下前列腺穿刺活检,除了行扩大范围系统活检外,并对前列腺内异常回声结节进行穿刺活检,分析其声像图特征与病理结果。结果:95例患者中,前列腺癌35例(36.8%),其中低回声结节16例(45.7%),强回声结节4例(11.4%),等回声结节10例(28.6%),混合性不均质回声5例(14.3%)。35例前列腺癌中,T2b期以内占46.2%(17/35),其中结节处检出前列腺癌阳性率70.6%(12/17),明显高于系统活检检出前列腺癌阳性率29.4%(5/17,P<0.05)。结论:对前列腺内异常回声结节的辨别与活检有利于前列腺疾病的诊断与鉴别诊断,并可提高早期前列腺癌诊断率,减少不必要的活检针数及减少患者不必要的痛苦,但它仍然不能代替传统的系统活检。Objective： To evaluate lesion-directed biopsy in improving the detection rate of early prostate cancer （PCa） and in differentiating PCa from other prostate pathological changes. Methods ： We performed TRUS-guided prostate biopsy for 95 patients suspected of PCa, each subjected to extended random biopsy plus lesion-directed biopsy, and analyzed the sonographie characteristics and pathological findings. Results： PCa was detected in 35 of the patients （36.8%）, including 16 hypoechoic （45.7%）, 4 hyperechoic （ 11.4% ） , 10 isoechoic （28.6%） and 5 mixed hetero-echoic lesions （ 14.3% ）. Of the 35 PCa cases, 17 （46.2%） were within T2b, 70.6% （ 12/17 ） of which were detected by lesion-directed biopsy and 29.4% （ 5/17 ） by sextant biopsy, the former obviously higher than the latter （P 〈 0. 05）. Conclusion ： Lesion-directed prostate biopsy under TRUS can significantly improve the early diagnosis of prostate cancer, increase convenience and reduce patients＇ pain, but is not sufficient to replace traditional sextant biopsy.

关 键 词：前列腺癌 穿刺活检 经直肠超声 

分 类 号：R737.25[医药卫生—肿瘤] R699.8[医药卫生—临床医学]