彩超引导下6点随机法前列腺活检的应用价值  

Evaluation of Color Ultrasound-Guided 6-Core Prostate Puncture Biopsy

作　　者：董晓秋[1] 张晨[1] 王晓民[1] 胡成乙[1] 赵长久[1] 

机构地区：[1]哈尔滨医科大学附属第四医院超声科,哈尔滨市150001

出　　处：《中国肿瘤临床》2009年第20期1160-1162,共3页Chinese Journal of Clinical Oncology

摘　　要：目的:探讨经直肠超声引导下对PSA增高伴直肠指检阳性和/或经直肠超声检查发现异常回声的临床可疑前列腺癌的患者6针随机改良法前列腺穿刺活检的应用价值。方法:对104例PSA>4.0ng/mL伴直肠指检阳性和/或经直肠超声检查异常回声的临床可疑前列腺癌的患者行经直肠超声引导下6针随机改良法前列腺穿刺活检,即在外腺、病变可疑处、血流丰富处顺时针方向重点取材6条组织,将活检病理结果与术后病理结果进行对照,并与经直肠超声引导下13针前列腺穿刺病理活检结果进行比较。结果:104例PSA增高的临床可疑前列腺癌的患者中,穿刺活检病理结果59例为前列腺腺癌,45例为前列腺增生。与术后病理结果对照穿刺活检阳性率100%,前列腺腺癌检出率56.7%(59/104)。与13针经直肠前列腺穿刺活检阳性率39%(20/51)相比,差异有显著性意义(P<0.05)。结论:本研究与传统的经直肠超声引导13针前列腺穿刺活检术相比,对PSA增高伴直肠指检阳性和/或经直肠超声检查发现异常回声的临床可疑前列腺癌的患者采用经直肠超声引导下6针随机改良法穿刺活检,在减少了穿刺针数,缩短了手术时间,减少患者痛苦和并发症发生的同时保证了标本的阳性检出率,具有一定的,临床应用价值,是一种安全、有效、微创的前列腺疾病诊断方法。Objective： To investigate the clinical value of transrectal color Doppler ultrasound-guided six-core prostate puncture biopsy for patients with high prostate specific antigen values and/or abnormal transrectal ultrasound in the diagnosis of prostate disease. Methods： A total of 104 patients with a prostate specific antigen value of 4.0ng/mL or higher and/or with abnormal digital rectal examination and/or abnormal transrectal ultrasound that were suspected of having prostate carcinoma underwent transrectal color Doppler ultrasound-guided six-core prostate puncture biopsy. Cores were taken from the external gland of the prostate, the suspected tumor location, and an area with more bloodstream. The pathological results of the six-core biopsy were compared with those obtained with the more established transrectal color Doppler ultrasound-guided thirteen-core prostate puncture biopsy. Results： The pathological findings demonstrated that 59 of the 104 cases with high prostate specific antigen value had carcinoma and the other 45 cases had benign prostate hyperplasia. Successful biopsies were obtained in 100% of the cases, and the detection rate of prostate carcinoma was 56.7% （59/104）. Compared with the 39% （20/51） successful detection rate of prostate carcinoma by transrectal color Doppler ultrasound-guided 13-core prostate puncture biopsy, the positive rate of detection by transrectal color Doppler ultrasound-guided random six-core prostate puncture biopsy was significantly higher （P〈0.05）. No severe complications were found among the patients that underwent transrectal color Doppler ultrasound-guided random six-core prostate puncture biopsy. Conclusion： Transrectal color Doppler ultrasound-guided random six-core prostate puncture biopsy can enhance the detection rate of prostate carcinoma, reduce the puncture frequency and surgical duration, and cause less pain and fewer complications.

关 键 词：前列腺癌 超声引导 穿刺活检 血清特异性抗源(PSA值) 

分 类 号：R737.25[医药卫生—肿瘤] R195.1[医药卫生—临床医学]