经直肠超声引导下经会阴前列腺穿刺活检联合复合前列腺特异抗原检测在前列腺癌诊断中的应用  

Clinical value of transrectal ultrasonography-guided biopsy combined with complexed prostate-specific antigen detection in diagnosis of prostate cancer

作　　者：朱雪萍[1] 章丽洁[1] 陈燕君[1] 朱乾雄 茅瑾瑜[1] 丁赫 耿和[2] 张涛[2] 袁亚[3] 张玉娜[4] 胡海强[4] 

机构地区：[1]上海市普陀区人民医院超声医学科,上海200060 [2]上海市普陀区人民医院泌尿外科,上海200060 [3]上海市普陀区人民医院病理科,上海200060 [4]上海市普陀区人民医院核医学科,上海200060

出　　处：《肿瘤影像学》2015年第2期134-137,142,共5页Oncoradiology

基　　金：上海市普陀区科委普陀区卫生系统自主创新科研资助项目(PTKW10-C01)

摘　　要：目的:探讨经直肠超声引导下经会阴前列腺10点穿刺法加可疑灶定点穿刺活检联合复合前列腺特异抗原(c PSA)检测在前列腺癌诊断中的临床应用价值。方法:147例临床拟诊前列腺癌患者在前列腺穿刺前行血清c PSA检测,采用经直肠超声引导下经会阴前列腺10点穿刺法加可疑灶定点穿刺活检术。结果:经直肠超声引导下经会阴前列腺10点穿刺法加可疑灶定点穿刺活检取材准确率为100%。147例临床拟诊患者前列腺癌穿刺活检阳性率为38.8%(57/147),其c PSA检测临界点为7.6 ng/m L。c PSA≥7.6 ng/m L 79例,诊断前列腺癌的灵敏度为93.8%,特异度为72.2%,前列腺穿刺活检阳性率达68.4%(54/79),46.3%的患者(68/147)可避免穿刺活检。结论:经直肠超声引导下经会阴前列腺10点穿刺法加可疑灶定点穿刺是一种安全可靠的诊断技术,c PSA以7.6 ng/m L为临界点,可显著增加前列腺穿刺活检的阳性率。Objective: To evaluate the clinical value of transrectal ultrasonography(TRUS)-guided 10-core plus fixed-point prostate biopsy combined with complexed prostate-specific antigen(c PSA) detection in the diagnosis of prostate cancer. Methods: c PSA was examined in 147 patients with suspected prostate cancer. All the patients underwent 10-core plus fixed-point prostate biopsy under the guidance of TRUS. Results: The accuracy of biopsy sampling was 100%. The positive rate of puncture biopsy was 38.8%(57/147) in 147 cases. The cutoff of c PSA was 7.6 ng/m L. There were 79 cases with c PSA more than or equal to 7.6 ng/m L. The specificity was 93.8% and the sensitivity was 72.2% for detecting prostate cancer when c PSA more than or equal to 7.6 ng/m L, and the positive rate of prostate biopsy was 68.4%(54/79). Puncture biopsy could be avoided in 46.3%(68/147) patients. Conclusion: TRUS-guided 10-core plus fixed-point prostate biopsy is a safe and reliable diagnostic method. When combined with c PSA with a cutoff of 7.6 ng/m L it can significantly increase the positive rate of prostate biopsy.

关 键 词：经直肠超声引导 前列腺穿刺活检 复合前列腺特异抗原 前列腺癌 

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