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目的:探讨超声引导下经会阴前列腺24针饱和穿刺活检与14针穿刺活检方案对PSA<20μg/L可疑前列腺癌患者的筛检阳性率及其相关并发症。方法:选取116例可疑前列腺癌患者行经会阴超声引导下14针穿刺活检(14针组),另136例患者,行经会阴24针饱和前列腺穿刺活检(24针饱和组),比较两组前列腺癌筛检阳性率、标本阳性率及穿刺后肉眼血尿、泌尿系感染、尿潴留等并发症的发生率。结果:两组患者平均年龄、穿刺前PSA水平、平均前列腺体积等指标均无统计学差异(P>0.05)。24针饱和组及14针组前列腺癌筛检总体阳性率分别为48.53%和17.24%,存在显著性差异(P<0.001),标本阳性率分别为8.09%和2.83%(P=0.012);其中24针饱和组前列腺尖部肿瘤的检出率(11.76%)显著高于14针组(1.72%,P<0.05)。两组穿刺后尿潴留、泌尿系感染和肉眼血尿等发生率均无统计学差异(P>0.05)。结论:24针经会阴前列腺饱和穿刺活检方法显著提高PSA<20μg/L患者中前列腺癌的筛检阳性率,尤其是增加了前列腺尖部区域的肿瘤筛检阳性率,而并未增加相关并发症。
Objective: To investigate the screening positive rate and related complications of PSA <20μg / L suspicious prostate cancer patients under ultrasound guided perineal prostate 24-needle saturation biopsy and 14-needle biopsy. Methods: One hundred and sixty-six patients with suspected prostate cancer underwent 14-needle biopsy guided by perineal ultrasound (group 14) and another 136 patients underwent perineal 24-needle saturated biopsy (24-needle saturation group) The positive rate, the positive rate of specimens and gross hematuria after puncture, urinary tract infection, urinary retention and other complications. Results: There was no significant difference in mean age, PSA level before pricking and mean prostatic volume between the two groups (P> 0.05). The overall positive rates of 24-needle-saturated group and 14-needle group were 48.53% and 17.24%, respectively (P <0.001), and the positive rates were 8.09% and 2.83% (P = 0.012) The detection rate of the prostatic tumor in the 24-needle-saturated group (11.76%) was significantly higher than that in the 14-needle group (1.72%, P <0.05). Urinary retention, urinary tract infection and gross hematuria in the two groups showed no significant difference (P> 0.05). Conclusion: The 24-pin transperineal needle biopsy method significantly improves the positive rate of prostate cancer screening in patients with PSA <20 μg / L, especially the positive rate of tumor screening in the prostatic apex without increasing the related complications .