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目的探讨经直肠超声检查(TRUS)引导下6点和6+X点前列腺穿刺法对前列腺癌(Pca)的临床诊断价值。方法对229例可疑Pca患者分别行TRUS引导下6点系统及6+X点穿刺活检,比较两者穿刺阳性率及统计指标差异性。结果 229例疑似患者经穿刺最终病理证实Pca 116例,前列腺增生(BPH)94例,前列腺炎6例,BPH伴炎性8例,前列腺梭形细胞瘤1例,前列腺结核3例,非典型增生1例。行6+X点穿刺法活检时灵敏度为100%、特异度为95.69%。111例Pca患者如仅按6点系统穿刺法活检,其特异度为100%、灵敏度为85.34%,将会有12例患者漏诊,其漏诊率为10.81%。结论 TRUS引导下的6+X点前列腺穿刺法可以明显提高Pca的检出率,为临床诊断、鉴别诊断及治疗方案的选择提供病理学依据。
Objective To investigate the clinical value of 6-point and 6 + X-point prostate puncture guided by transrectal ultrasound (TRUS) in the diagnosis of prostate cancer (Pca). Methods 229 suspicious patients with Pca underwent TRUS-guided 6-point system and 6 + X puncture biopsy, the positive rate of the puncture and statistical differences between the two indicators. Results A total of 229 cases of Pca were confirmed by puncture in the final pathology. The results showed that there were 116 cases of Pca, 94 cases of benign prostatic hyperplasia (BPH), 6 cases of prostatitis, 8 cases of BPH with inflammation, 1 case of prostatic spindle cell tumor, 3 cases of prostate tuberculosis, 3 cases of atypical hyperplasia 1 case. Line 6 + X point biopsy biopsy sensitivity was 100%, specificity was 95.69%. 111 patients with Pca who had biopsied by only 6-point system had a specificity of 100% and a sensitivity of 85.34%. Twelve patients were missed and the rate of missed diagnosis was 10.81%. Conclusion The 6 + X point prostate puncture under the guidance of TRUS can significantly increase the detection rate of Pca and provide a pathological basis for the clinical diagnosis, differential diagnosis and treatment options.