多模态影像引导经会阴前列腺靶向活检与系统活检的对比研究  

Comparative analysis of transperineal systematic biopsy versus transperineal multimodalimaging targeted biopsy for the detection of prostate cancer

作　　者：黄志武 蓝中凯 石才够 农有祥 齐鲁 杨剑文[1] 梁国 张步林[1] HUANG Zhi-wu;LAN Zhong-kai;SHI Cai-gou;NONG You-xiang;QI Lu;YANG Jian-wen;LIANG Guo;ZHANG Bu-lin(Liuzhou People’s Hospital Affiliated to Guangxi Medical University,Liuzhou Guangxi 545006,China)

机构地区：[1]广西医科大学附属柳州市人民医院,广西柳州545006

出　　处：《中国临床医学影像杂志》2024年第9期641-645,共5页Journal of China Clinic Medical Imaging

基　　金：广西卫生健康委员会自筹项目(编号:Z20212023)。

摘　　要：目的:比较多模态影像引导经会阴(Transperineal,TP)靶向穿刺与TP系统穿刺前列腺癌(Prostate cancer,PCa)的检出率。方法:将120例临床疑似PCa患者随机分成系统组60例与靶向组60例,分别行TP穿刺活检,系统组每例12针,靶向组每例10~14针。靶向组患者穿刺前行多模态超声或/和多参数MRI(mp-MIR)检查,实施8+X(系统+可疑病灶)的穿刺策略。比较两组PCa检出率。结果:两组间PCa及无临床意义PCa检出率的差异无统计学意义(P>0.05),而靶向组有临床意义PCa(Clinically significant prostate cancer,csPCa)的检出率高于系统组(χ^(2)=10.497,P=0.038)。靶向组中单针穿刺阳性率高于系统组(31.09%vs. 23.47%;χ^(2)=10.497,P=0.001)。两组间PCa患者Gleason评分分布差异无统计学意义(χ^(2)=8.213,P=0.084)。两组患者术后均无严重并发症发生。结论:与TP系统穿刺对比,TP靶向穿刺csPCa的检出率更高,多模态影像在提高csPCa的检出率中具有临床应用价值。Objective:To compare the detection rates of prostate cancer(PCa)between the transperineal(TP)systematic biopsy and TP multimodal imaging targeted biopsy.Methods:A total of 120 clinically suspected PCa patients were randomly divided into a systematic group(n=60)and a targeted group(n=60).TP biopsy was performed separately,with 12 cores per case in the systematic group and 10~13 cores per case in the targeted group.Targeted group patients underwent multimodal ultrasound or/and multi-parameter MRI(mp-MIR)examination before biopsy,and an 8+X(systematic+suspicious lesion)biopsy strategy was implemented.The detection rates of PCa between two groups were compared.Results:There were no statistically significant differences in the detection rates of PCa and non clinically significant PCa between the two groups(P>0.05),while the detection rate of clinically significant prostate cancer(csPCa)in the targeted group was higher than that in the system group(χ^(2)=10.497,P=0.038).The positive rate of single core for prostate cancer in the targeted group was higher than that in the systematic group(31.09%vs.23.47%;χ^(2)=10.497,P=0.001).There was no statistically significant difference in Gleason score distribution between the two groups of PCa patients(χ^(2)=8.213,P=0.084).Both groups of patients had no serious postoperative complications.Conclusions:Compared with systematic TP biospy,targeted TP biopsy has a higher detection rate of csPCa,and multimodal imaging has clinical application value in improving the detection of csPCa.

关 键 词：前列腺肿瘤 超声检查 介入性 磁共振成像 

分 类 号：R737.25[医药卫生—肿瘤] R445.1[医药卫生—临床医学] R445.2