论文部分内容阅读
[目的]探讨经直肠超声引导下前列腺穿刺活检术对诊断前列腺疾病的临床应用效果。[方法]对163例临床怀疑前列腺癌患者,行经直肠超声引导前列腺穿刺活检术,并对结果进行回顾性统计分析。入选患者为前列腺特异性抗原(PSA)>4μg/L,和(或)B超或直肠指检发现前列腺结节者。对于PSA在4～10μg/L者,结合游离PSA/总PSA比值(F/T),<0.16者行穿刺术。前列腺穿刺活检取材方案为6～12针。[结果]163例患者病理证实前列腺腺泡癌76例,良性前列腺增生58例,前列腺不典型增生16例,慢性前列腺炎症8例,前列腺内皮瘤形成5例。前列腺癌穿刺阳性率为46.6%。引入游离PSA/总PSA比值后,能提高PSA在4～10μg/L患者中的穿刺阳性率,但差异未达到统计学意义。术后并发症主要为血尿、大便表面带血、发热,发生率分别为45.4%、7.4%、1.8%。[结论]经直肠超声引导前列腺穿刺活检术安全有效,对前列腺癌早期诊断具有较高临床应用价值。结合PSA以及游离PSA/总PSA比值可以有效提高前列腺穿刺阳性率。
[Objective] To investigate the clinical effect of transrectal ultrasound-guided prostate biopsy on the diagnosis of prostate diseases. [Method] 163 cases of clinically suspected prostate cancer patients underwent transrectal ultrasound guided prostatic biopsy, and the results were retrospectively analyzed. Selected patients with prostate-specific antigen (PSA)> 4μg / L, and (or) B-or digital rectal examination revealed prostate nodules. For PSA at 4 ~ 10μg / L, combined with free PSA / total PSA ratio (F / T), <0.16 were puncture. Prostate biopsy material plan for the 6 to 12-pin. [Results] Totally 76 cases of prostatic adenocarcinoma, 58 benign prostatic hyperplasia, 16 prostatic hyperplasia, 8 chronic prostatitis and 5 prostatic intraepithelial neoplasia were confirmed in 163 cases. Prostate cancer puncture positive rate was 46.6%. The introduction of free PSA / total PSA ratio can improve the PSA positive rate in 4 ~ 10μg / L patients, but the difference did not reach statistical significance. Postoperative complications mainly hematuria, stool surface blood, fever, the incidence was 45.4%, 7.4%, 1.8%. [Conclusion] Transrectal ultrasound-guided prostatic biopsy is safe and effective and has a high clinical value for the early diagnosis of prostate cancer. Combined with PSA and free PSA / total PSA ratio can effectively improve the positive rate of prostate biopsy.