目的评价经直肠超声引导5区13针前列腺穿刺活检在筛查前列腺癌的临床应用价值。方法对102例患者,年龄49-75岁,平均64.2岁,以前列腺特异性抗原(PSA)4-10ng/ml且游离PSA/总PSA<0.26或PSA10.1-50ng/ml或直肠指诊检查(DRE)异常或B超发现异常回声为穿刺指征,前列腺体积12-109ml,平均49ml,在直肠腔内注入1%盐酸丁卡因凝胶10ml局部粘膜麻醉下行经直肠超声引导5区13针前列腺系统穿刺活检。结果102例患者全部穿刺成功,前列腺癌活检阳性率为23.5%,PSA0-4ng/ml、PSA4.1-10ng/ml、PSA10.1-50ng/ml阳性率分别为9.1%(1/11)、15.4%(6/39)、32.1%(17/53)。前列腺体积<20、20-40ml、40-60ml及>60ml阳性率分别为62.5%(5/8)、27.0%(10/37)、14.3%(7/49)、25.0%(2/8)。术中出现血管迷走神经反应2例,3例直肠大出血,9例术后出现发热,上述患者经相关处理后恢复。结论经直肠超声引导5区13针前列腺穿刺活检术是一种筛查前列腺癌阳性率较高的方法,但在应用中有可能发生一些并发症。术后仔细观察病情变化,预防严重并发症的发生。 Objective To evaluate the clinical value of transrectal ultrasound-guided 5-zone 13-pin prostatic biopsy in the screening of prostate cancer. Methods 102 patients aged 49-75 years, mean 64.2 years, with PSA-4-10 ng / ml and free PSA / total PSA <0.26 or PSA 0.1-50ng / ml or digital rectal examination (DRE) Abnormal or B ultrasound found abnormal Echocardiography puncture indications, prostate volume 12-109ml, an average of 49ml, in the rectum cavity injection of 1% tetracaine hydrochloride gel 10ml local mucosal anesthesia under transrectal ultrasound guided 5 zone 13-pin Prostate system biopsy. Results The positive rate of prostate biopsy in 102 patients was 23.5%. The positive rates of PSA0-4ng / ml, PSA4.1-10ng / ml and PSA10.1-50ng / ml were 9.1% (1/11) 15.4% (6/39), 32.1% (17/53). The positive rates of prostate volume of 20,20-40ml, 40-60ml and> 60ml were 62.5% (5/8), 27.0% (10/37), 14.3% (7/49) and 25.0% (2/8) . Intraoperative vasovagal reactions in 2 cases, 3 cases of rectal bleeding, 9 cases of postoperative fever, the patient recovered after treatment. Conclusion Transrectal ultrasound-guided 5-zone 13-pin prostatic biopsy is a method of screening for higher positive rates of prostate cancer, but some complications may occur in the application. After careful observation of changes in condition, to prevent the occurrence of serious complications.