MRI/US成像融合引导的经会阴前列腺穿刺活检的单中心研究  

MRI/US imaging fusion guided transperineal prostate biopsy:a research in single center

作　　者：熊轶[1] 张古田[1] 汪维[1] 张青[1] 云天纬 史炯[2] 樊祥山[2] 张冰[3] 刘晓宙[4] 郭宏骞[1] 

机构地区：[1]南京大学医学院附属鼓楼医院泌尿外科,南京210008 [2]南京大学医学院附属鼓楼医院病理科 [3]南京大学医学院附属鼓楼医院放射科 [4]近代声学教育部重点实验室南京大学声学所

出　　处：《临床泌尿外科杂志》2018年第1期39-43,共5页Journal of Clinical Urology

基　　金：国家自然科学基金(编号11774167)

摘　　要：目的:评估磁共振/超声(MRI/US)成像融合引导的经会阴前列腺穿刺活检对前列腺癌诊断的价值。方法:回顾性分析2014年9月~2016年3月我院行MRI/US成像融合引导的经会阴前列腺穿刺活检的121例患者资料,每例均行12针系统性穿刺活检(SB)+每个目标靶点(ROI)2针靶向穿刺活检(TB)。活检标本行病理学分析,获知Gleason评分和阳性单针癌组织长度。记录所有患者的临床、影像及病理资料,采用t检验、秩和检验、卡方检验等统计学方法对各项数据进行分析对比。结果:TB的前列腺癌单针阳性率(20.0%)以及高危前列腺癌单针阳性率(10.3%)均明显高于SB(12.7%和5.5%),差异均有统计学意义(P=0.001和P=0.002);TB的阳性单针癌组织长度高于SB,差异有统计学意义(P=0.046);TB的阳性针癌组织主要分化程度的Gleason评分、次要分化程度的Gleason评分、Gleason总评分均高于SB,但差异无统计学意义(P>0.05)。结论:MRI/US成像融合引导的前列腺穿刺活检中的TB较SB能够更有效地检出高危前列腺癌。在条件允许的情况下可推广应用MRI/US成像融合引导的前列腺穿刺活检技术。Objective：To evaluate the efficacy of magnetic resonance imaging/ultrasound（MRI/US）imaging fusion guided transperineal prostate biopsy for the diagnosis of prostate cancer.Method：From September 2014 to March 2016,121 cases were hospitalized for MRI/US imaging fusion guided transperineal prostate biopsy and their data were analyzed retrospectively.Each case underwent systematic 12-core biopsy（SB）add 2-core targeting biopsy（TB）per region of interest（ROI）.Pathological findings of each biopsy core was analyzed for Gleason grade and the single-core length of prostate cancer.We recorded the clinical,imaging and pathological data of all cases.We analyzed various data by t test,rank sum test and chi-square test.Result：TB had an obvious higher single-core positive rate for prostate cancer（20.0%）and an obvious higher single-core positive rate for high-risk prostate cancer（10.3%）than those of SB（12.7% and 5.5%）,with the statistically significant difference（P=0.001 and P=0.002）.TB had a higher single-core length of prostate cancer than that of SB,with the statistically significant difference（P=0.046）.Positive cores of TB had a higher primary Gleason grade,secondary Gleason grade and Gleason score compared with positive cores of SB,without statistically significant difference（P0.05）.Conclusion：When taking MRI/US imaging fusion guided transperineal prostate biopsy,TB can detect high-risk prostate cancer more effectively than SB can.MRI/US imaging fusion guided transperineal prostate biopsy is worth promoting if it is permitted.

关 键 词：前列腺癌 成像融合 磁共振 超声 靶向穿刺 

分 类 号：R737.25[医药卫生—肿瘤]