大体病理评分在超声引导下前列腺活检中的价值  

The value of gross pathological scores in ultrasound guided prostate biopsy

作　　者：李成[1] 詹维伟[1] 江文君 罗方秀[2] 张敏光 Li Cheng;Zhan Weiwei;Jiang Wenjun;Luo Fangxiu;Zhang Minguang(Department of Ultrasound,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Pathology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Urology,Huashan Hospital,Fudan University School of Medicine,Shanghai 200040,China)

机构地区：[1]上海交通大学医学院附属瑞金医院超声科,上海200025 [2]上海交通大学医学院附属瑞金医院病理科,上海200025 [3]复旦大学医学院附属华山医院泌尿外科,上海200040

出　　处：《中国男科学杂志》2021年第1期18-21,63,共5页Chinese Journal of Andrology

摘　　要：目的对前列腺癌穿刺活检标本进行大体病理评分,以便在减少穿刺针数的同时提高前列腺癌穿刺诊断的阳性率。方法本组268例可疑前列腺癌患者,进行超声引导下前列腺穿刺活检,获得1608条前列腺组织标本。标本由一位超声科主治医师、一位泌尿外科主治医师和一位病理科主治医师对所取标本进行独立的目测观察,从硬度、颜色、饱满度、透明度和均匀度等五方面对标本评分。汇总三个人对标本的评分,评分不一致者取平均值,采用四舍五入取整数。结果目测评分与总的前列腺特异性抗原(tPSA)之间具有直线相关关系(r=0.348);Logistic回归分析表明目测评分和PSA在诊断疾病方面具有统计学意义;目测评分在预测性诊断方面的真实性高于PSA;以目测评分预测前列腺癌的最佳灵敏度和特异度分别为0.790和0.932。结论采用目测评分前列腺穿刺标本的方法可以减少穿刺针数、提高穿刺阳性率、减少穿刺后并发症。在相同创伤情况下,前列腺癌活检阳性率明显提高,在相同前列腺癌活检阳性率的情况下,术后并发症明显减低,无严重并发症。Objective To evaluate the value of gross pathological scores in ultrasound guided prostate biopsy,and clarify whether it help to reduce the number of biopsy core and improve the positive diagnosis rate of prostate biopsy.Methods Total of 268 suspicious prostate cancer patients underwent ultrasound guided prostate biopsy,and 1608 prostate specimens were obtained.The specimens were visually observed independently by an attending physician of ultrasound department,an attending physician of urology department and an attending physician of pathology department.The specimens were scored based on hardness,color,plumpness,transparency and uniformity.If the scores of three people are inconsistent,the average value(use rounding to get the integer)was defined as the final result.Results There was a linear correlation between the visual scores and the total prostate specific antigen(t PSA)(r=0.348).Logistic regression analysis showed that the visual scores and the PSA were statistically significant in diagnosing disease.The facticity of visual scores in predictive diagnosis was higher than that of PSA.The best sensitivity and specificity of visual scores in predicting prostate cancer were0.790 and 0.932 respectively.Conclusion Visual scoring of prostate biopsy specimens can reduce the number of biopsy core,improve the positive rate of biopsy,and reduce the biopsy-caused complications.Under the same trauma,the positive rate of prostate cancer biopsy was significantly increased.Under the same positive rate of prostate cancer biopsy,the postoperative complications were significantly reduced and no serious complications occurred.

关 键 词：前列腺肿瘤 超声引导下前列腺穿刺 标本评分 阳性率 

分 类 号：R737.25[医药卫生—肿瘤] R446.83[医药卫生—临床医学]