超声引导下前列腺12针系统穿刺活检增加前列腺癌检出率的研究  

Transrectal ultrasound-guided systematic 12-core biopsy of the prostate improves prostate cancer detection

作　　者：李秋洋[1] 唐杰[1] 李岩密[1] 费翔[1] 张艳[1] 何恩辉[1] 周昀[1] 

机构地区：[1]解放军总医院超声科,北京100853

出　　处：《中华男科学杂志》2011年第12期1064-1068,共5页National Journal of Andrology

基　　金：国家科技支撑计划项目(2009BAI86B05);中国人民解放军总医院博士研究生创新项目(10BCZ02)~~

摘　　要：目的:探讨不同年龄及前列腺特异性抗原(PSA)分组对12针穿刺活检前列腺癌检出率及肿瘤特征的影响。方法:临床表现怀疑前列腺癌患者210例,按照患者的年龄分为≤59岁组、60～69岁组、70～79岁组、≥80岁组,按照PSA水平分为0～4μg/L组、4.1～10μg/L组、10.1～20μg/L组、20.1～50μg/L组、>50μg/L组,记录患者临床资料及活检结果。提出不同的穿刺方案并计算其检出率。结果:210例怀疑为前列腺癌患者,检出前列腺癌91例,总的前列腺癌检出率为43.3%,随着年龄的增长,PSA水平的提高,检出率逐渐提高。年龄的增长、PSA水平的提高与体积较大、分级较高的肿瘤密切相关。外周带穿刺与旁正中矢状尖部穿刺有较高的前列腺癌检出率。当患者年龄<60岁,PSA水平<20μg/L时,12针穿刺活检为较佳方案。结论:12针穿刺活检可以弥补6针穿刺活检的缺陷,随着患者年龄的增长,PSA水平的提高,肿瘤的体积增大、病理分级较差。传统6针穿刺法与12针相比,受患者年龄、PSA水平的影响较大。Objective： To evaluate transreetal ultrasound-guided systematic 12-core biopsy of the prostate for the detection and characterization of prostate cancer in different age and prostate specific antigen （PSA） groups. Methods： Totally 210 patients were divided into four age groups （ ≤59 yr, 60 -69 yr, 70 -79 yr, and 380 yr） and five PSA groups （0 -4 μg/L, 4. 1 - 10 μg/L, 10. 1 -20 μg/L, 20.1 -50 μg/L, and 〉 50 μg/L） , and underwent trausrectal ultrasound-guided systematic 12-core biopsy of the prostate at various sites for detecting prostate cancer. Clinical data and the results of various biopsy schemes were analyzed and compared. Results： Ninety-one cases of prostate cancer were detected among the 210 patients, with a total detection rate of 43.3%, and the percentage was higher with the increase of age and PSA level. Larger and higher-grade tumors were associated with older age and higher PSA level, and higher detection rates were related to laterally directed and apical biopsies. The 12-core biopsy outperformed other biopsy schemes in detecting prostate cancer in patients under 60 years of age and with PSA 〈 20 μg/L. Conclusion ： The 12-core biopsy scheme can make up for the inadequacy of sextant biopsy in detecting prostate cancer, and less influenced by the age and PSA level of the patients. Generally larger and higher-grade tumors are associated with older age and higher PSA level.

关 键 词：前列腺 穿刺活检 前列腺癌 前列腺特异性抗原 

分 类 号：R737.25[医药卫生—肿瘤]