摘要
目的探讨超声引导下经直肠饱和穿刺在临床疑诊为前列腺癌但首次活检阴性患者中的诊断价值,评价其有效性和安全性。方法 将120例因前列腺特异抗原(PSA)和(或)直肠指检异常而接受前列腺12针穿刺活检、且结果为阴性的患者纳入研究,随机分为扩大穿刺组(采用12针扩大穿刺法)和饱和穿刺组(采用24针饱和穿刺法),行超声引导下经直肠重复穿刺活检。对两组患者均行前列腺周围神经阻滞术,穿刺活检过程中观察患者情况,并采用视觉模拟评分(VAS)评估疼痛程度。结果 两组患者年龄、总PSA水平、PSA密度、前列腺总体积及移行区体积、首次穿刺病理、直肠指诊情况、穿刺活检过程中患者VAS和术后并发症差异均无统计学意义(P均>0.05)。饱和穿刺组前列腺体积>60ml者的穿刺阳性率高于扩大穿刺组(P=0.033),其穿刺总体阳性率亦高于扩大穿刺组(31.67%vs 15.00%,P=0.031)。结论 经直肠饱和穿刺活检可以提高临床疑诊前列腺癌但首次活检阴性者的前列腺癌检出率,且不增加并发症发生率。
Objective To investigate diagnostic value of transrectal ultrasound-guided saturation prostate biopsy protocols after initial negative biopsy result and to assess the efficacy and safety. Methods A total of 120 patients with elevated prostate specific antigen （PSA） and/or abnormal digital rectal examination after initial negative biopsy enrolled in this study and were randomly divided into extended biopsy group and saturation biopsy group, each group had 60 patients with repeat biopsy. The extended biopsy group used 12-core repeat biopsy and the saturation biopsy group used 24-core repeat biopsy. Periprostatic nerve block was performed in the two groups. The pain and discomfort were estimated based on visual analog scale （VAS）. Results There was no significantly different in age, serum total PSA, PSA density, prostate volume, tran sition zone volume, previous pathology, digital rectal examination VAS and postoperative complications between the two groups （all P〉0.05）. The total cancer detection rate of saturation biopsy group was higher than that of extended biopsy group （31.67% vs 15.00%, P=0. 031）, the improvement of cancer detection rate was higher only when the prostate vol ume was greater than 60 ml （P=0, 033）. Conclusion The transrectal ultrasound-guided saturation prostate biopsy can im prove the detection rate of prostate cancer after initial negative result, and does not increase complications.
出处
《中国介入影像与治疗学》
CSCD
2012年第9期648-651,共4页
Chinese Journal of Interventional Imaging and Therapy
作者简介
许宁（1982-），男，福建福清人，硕士，主治医师。研究方向：前列腺癌的基础和临床研究。E-mail：drxuning@gmail．com
薛学义，福建医科大学附属第一医院泌尿外科，350005。E-mail：drxun@163．com
