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目的探讨前列腺癌(PCa)的超声影像与超声引导下6点系统活检病理学检查的关系,提高早期PCa检出率。方法研究对象为PCa集团普查发现的血清PSA>4.0ng/ml的329例经直肠超声引导下前列腺活检受检者,每位受检者均行血清PSA检测及前列腺活检病理诊断。结果(1)329例接受前列腺活检病例中PCa患者93例(28.3%),其中前列腺腺癌88例,其他类型癌5例。(2)93例PCa患者的超声影像中见低回声反射区组为56例(60.2%),其余37例为无异常回声组(39.8%)。(3)88例前列腺腺癌中,53例低回声反射区组PSA平均值为(60.50±39.79)ng/ml,35例无异常回声组PSA平均值为(12.74±8.25)ng/ml,两组比较差异显著(P<0.001)。PSA含量4.0￣10.0ng/ml区间者17例,无低回声反射区者15例,占88.2%。(4)早期病例(A,B期)中无异常回声组占82.9%。结论在超声影像学无异常的血清PSA增高的人群中,经超声引导下前列腺活检能够发现早期PCa。
Objective To investigate the relationship between ultrasonic imaging of prostate cancer (PCa) and ultrasound-guided 6-point biopsy and to improve the detection rate of early PCa. Methods The subjects were prostate biopsy-guided prostate biopsy under the guidance of rectal ultrasound in 329 cases of serum PSA> 4.0ng / ml detected by the PCa group. Each subject underwent serum PSA test and pathological diagnosis of prostate biopsy. Results (1) Of the 329 PCa patients who underwent prostate biopsy, 93 (28.3%) had PCa, of which 88 were prostate cancer and 5 were other types of cancer. (2) Among 93 PCa patients, 56 cases (60.2%) had hypoechoic echo group and 39 cases (39.8%) had abnormal echo group. (3) In 88 cases of prostatic adenocarcinoma, the mean PSA of 53 cases with low echo reflex zone was (60.50 ± 39.79) ng / ml and that of 35 cases without abnormal echo was (12.74 ± 8.25) ng / ml, The difference was significant (P <0.001). There were 17 cases in the PSA range of 4.0-10.0ng / ml, and 15 cases (88.2%) in the non-hypoechoic area. (4) In the early cases (A, B) no abnormal echo group accounted for 82.9%. Conclusions Ultrasound-guided prostate biopsy can detect early stage PCa in patients with elevated serum PSA without abnormal ultrasound imaging.