经直肠超声引导13点法前列腺穿刺活检术诊断前列腺癌  

The clinical study of transrectal ultrasound guided systematic 13 cases prostate biopsy for diagnosing prostate carcinoma

作　　者：胡建波[1] 杨柳平[1] 钟红[2] 魏鸿蔼[1] 王良圣[1] 余安迪[1] 

机构地区：[1]广州市第一人民医院泌尿外科,广州510180 [2]广州市第一人民医院B超室

出　　处：《临床泌尿外科杂志》2001年第11期476-477,共2页Journal of Clinical Urology

摘　　要：目的 :评价经直肠超声引导 13点法前列腺系统穿刺活检术诊断前列腺癌的临床价值。方法 :按照Eskew描述的方法 ,在标准的经直肠超声引导 6点法前列腺系统穿刺活检术的基础上 ,增加在前列腺的中间部位及前列腺两侧旁正中线远侧的穿刺点数 ,总共穿刺活检 13处。将增加的 7处活检部位的病理结果与标准的 6点法前列腺系统穿刺活检术进行比较 ,并对经直肠超声引导 13点法前列腺系统穿刺活检术的并发症进行了讨论。结果 :总共 5 1例患者中有 2 0例确诊为前列腺癌 (2 0 / 5 1) ,占 39% ,此 2 0例前列腺癌患者若仅采用标准的经直肠超声引导 6点法前列腺系统穿刺活检术 ,将有 5例患者漏诊 ,占 2 5 %。所有接受经直肠超声引导 13点法前列腺系统穿刺活检术的患者无一例出现严重的并发症。结论 :经直肠超声引导 13点法前列腺系统穿刺活检术可明显提高前列腺癌的临床检出率 ,是一种安全、有效的前列腺系统穿刺活检术式 ,值得在临床推广应用。Purpose:To evaluate the clinical value of transrectal ultrasound guided systematic 13 cores prostate biopsy.Methods:A total of 51 patients referred for abnormal digital rectal examination and/or prostate specific antigen 4 ng/ml or greater underwent transrectal ultrasound guided systematic 13 cores prostate biopsy.That was,in addition to standard sextant biopsies,cores were taken from the far lateral and middle regions of the gland as described by Eskew.Pathological findings of the additional regions were compared with those of the sextant regions.We also discussed the complications of the 13 cores prostate biopsy.Results:Of the patients 39% had cancer on biopsy(20/51).Of the 20 patients with prostate cancer 5(25%)had carcinoma only in the additional regions,which would have remained undetected had the sextant biopsy technique been used alone(P< 0.05 ).No severe complications could be found among the patients who underwent transrectal ultrasound guided systematic 13 cores prostate biopsy.Conclusions:Our data demonstrated that transrectal ultrasound guided systematic 13 cores prostate biopsy could increase the cancer detection rate significantly.We have found this technique is safe and efficacious,and should be recommended for use in clinic.

关 键 词：前列腺肿瘤 针吸活组织检查 超声引导 诊断 

分 类 号：R737.25[医药卫生—肿瘤] R730.43[医药卫生—临床医学]