摘要
目的探讨局部麻醉下经会阴磁共振成像-超声融合前列腺靶向穿刺用于既往活检阴性,但是前列腺特异抗原(prostate specific antigen,PSA)持续升高患者的诊断价值。方法选取2018年7月至2021年3月在青岛大学附属烟台毓璜顶医院泌尿外科已行前列腺穿刺的56例患者,56例患者均行经会阴系统穿刺,52例患者在此基础上行磁共振成像-超声融合靶向穿刺,对不同穿刺方案的病理结果进行统计分析。结果56例患者均顺利完成前列腺穿刺活检,均无严重并发症发生。病理确诊的总前列腺癌(prostate cancer,PCa)为23例,阳性率41.07%,其中临床有意义前列腺癌(clinically significant prostate cancer,csPCa)16例(69.87%)。融合穿刺检出PCa 14例,csPCa 12例(85.71%);系统穿刺检出PCa 18例,csPCa 10例(55.56%)。单因素分析表明,csPCa与更大的年龄(P=0.001)、更小的前列腺体积(P=0.000)、更高的PSA浓度(P=0.001)以及磁共振成像评分5分(P=0.000)相关。Logistic回归分析表明,磁共振成像评分5分为csPCa的独立预测因素。结论局麻下经会阴融合穿刺联合系统穿刺安全有效,能提高前列腺重复穿刺患者PCa及csPCa的检出率。
Objective This study investigated the diagnostic value of transperineal magnetic resonance imaging ultrasound fusion prostate targeted puncture under local anesthesia in patients with a previous negative biopsy but a continual increase in prostate specific antigen(PSA).Methods A total of 56 patients who had undergone transrectal ultrasound prostate puncture at Yantai Yuhuangding Hospital Affiliated with Qingdao University between July 2018 and March 2021 were studied.Some patients underwent additional targeted puncture.The pathological results of the different puncture schemes were statistically analyzed.Results A total of 56 patients successfully completed prostate biopsy,and no serious complications were observed.A total of 23 cases of prostate cancer(PCA)were confirmed by pathology,with a positivity rate of 41.07%,and 16 cases of clinically significant prostate cancer(csPCa)were confirmed(69.87%).A total of 14 cases of PCA and 12 cases of csPCa were detected by fusion puncture(85.71%).PCA was detected in 18 cases,and csPCa was detected in 10 cases(55.56%).Univariate analysis showed that csPCa was associated with older age(P=0.001),smaller prostate volume(P=0.000),higher PSA concentration(P=0.001)and magnetic resonance imaging score 5(P=0.000).Logistic regression analysis showed that MRI score of 5 was an independent predictor of csPCa.Conclusion Transperineal fusion puncture combined with systematic puncture under local anesthesia is safe and effective,and can improve the detection rate of PCA and csPCa in patients with repeated prostate puncture.
作者
欧阳奎
蒋晓舻
袁贺佳
窦卫超
冯帆
吴吉涛
赵红伟
Ouyang Kui;Jiang Xiaoyu;Yuan Hejia;Dou Weichao;Feng fan;Wu Jitao;Zhao Hongwei(Department of Urology,Yantai Yuhuangding Hospital Affiliated to Qingdao University,Yantai,Shandong,264000,China)
出处
《泌尿外科杂志（电子版）》
2021年第4期88-91,96,共5页
Journal of Urology for Clinicians(Electronic Version)
关键词
前列腺癌
磁共振成像
超声融合技术
前列腺活检
局部浸润麻醉
Prostate cancer
Magnetic resonance imaging
Ultrasonic fusion technology
Prostate biopsy
Local infiltration anesthesia
作者简介
通讯作者:赵红伟,E-mail:zhaohw8107@126.com
