經(jīng)直腸超聲造影輔助前列腺穿刺活檢與前列腺系統(tǒng)穿刺活檢在前列腺癌診斷中的比較研究

洪惲+陳軍

【摘要】目的：分析并探討經(jīng)直腸超聲造影輔助前列腺穿刺活檢與前列腺系統(tǒng)穿刺活檢的差異。方法：選取2010年1月至2015年5月期間在我院接受治療的可疑前列腺癌患者300例，分為觀察組和對照組，每組150例。觀察組采用經(jīng)直腸前列腺超聲造影輔助前列腺穿刺活檢，對照組則采用系統(tǒng)的前列腺12針穿刺活檢。結(jié)果：觀察組前列腺癌57例，占38.00%，人均穿刺（9.3±1.4）針，單針陽性率為18.21%，Gleason評分為（7.1±0.5）分。對照組前列腺癌54例，占35.33%，人均穿刺12針，單針陽性率為11.17%，Gleason評分為（6.6±0.5）分。兩組前列腺癌診斷率無顯著差異，觀察組其他各項指標(biāo)明顯優(yōu)于對照組，經(jīng)統(tǒng)計學(xué)檢驗，差異具有統(tǒng)計學(xué)意義（P<0.05）。觀察組造影異常70例（46.7%），確診前列腺癌41例，人均穿刺（6.19±0.7）針，單針陽性率為43.91%（191/435）；觀察組造影正常80例（53.3%），確診前列腺癌16例，人均穿刺12針，單針陽性率為6.56%（63/960）。結(jié)論：經(jīng)直腸超聲造影輔助前列腺穿刺活檢與前列腺系統(tǒng)穿刺活檢相比效率更高，臨床上值得推廣。

【關(guān)鍵詞】前列腺穿刺活檢；超聲造影；超聲

Comparative study of trans-rectal ultrasound contrast-assisted prostate biopsy and prostate system biopsyHONG Yun1， CHEN Jun2. 1.Department of Urology， Wenling Fourth Peoples Hospital， Taizhou 317511， Zhejiang， China； 2.Department of Urology， Wenling First Peoples Hospital， Taizhou 317500， Zhejiang， China

【Abstract】Objectives： To analyze and discuss the differences between trans-rectal ultrasound contrast-assisted prostate biopsy and prostate system biopsy. Methods： 300 cases of suspected prostate cancer treated in in Wenling City Fourth Peoples Hospital from January 2010 to May 2015 were selected and divided into two groups as control group and observation group， with 150 cases in each group. Observation group received trans-rectal ultrasound-assisted prostate biopsy and control group received 12 prostate needles biopsy. Results： There were 57 cases of prostate cancer in observation group， accounting for 38.00%， per capita puncture （9.3 ± 1.4）. Single needle positive rate was 18.21% and Gleason score was （7.1 ± 0.5） points. There were 54 cases of prostate cancer in control group， accounting for 35.33%， per capita puncture （12）. Single needle positive rate was 11.17% and Gleason score was （6.6 ± 0.5） points. There were no significant differences in prostate cancer diagnosis between observation group and control group. Other indicators in observation group were better than these in control group， with statistically significant difference （P<0.05）. There were 70 cases of abnormal radiography in observation group （46.7%）， with 41 cases of prostate cancer and per capita puncture （6.19 ± 0.7）. Single needle positive rate was 43.91% （191/435）； in observation group， there were 80 cases of normal radiography （53.3%）， with 16 cases of prostate cancer and per puncture （12）. Single needle positive rate was 6.56% （63/960）. Conclusion： Trans-rectal ultrasound contrast-assisted prostate biopsy is more efficient than prostate system biopsy， which is worth promoting in clinic.endprint

【Key words】Prostate biopsy； Ultrasound contrast； Ultrasound

【中圖分類號】R737.25【文獻標(biāo)志碼】A

前列腺癌是一種常見的男性前列腺上皮惡性腫瘤，早期發(fā)現(xiàn)、及時治療可有效提高患者5年內(nèi)生存率，改善患者生存質(zhì)量[1]。目前臨床中普遍應(yīng)用前列腺穿刺活檢對前列腺癌進行診斷，隨著科技的逐步發(fā)展，穿刺活檢中可伴隨多種方式進行引導(dǎo)，從而提高穿刺成功率[2]。超聲引導(dǎo)是最常見的輔助引導(dǎo)穿刺方式，但據(jù)報道顯示經(jīng)直腸超聲引導(dǎo)所需穿刺針數(shù)多，給患者帶來較大痛苦，因此如何適當(dāng)改善超聲引導(dǎo)使其保證診斷率的同時降低所需穿刺數(shù)將提高患者依從性，降低其診斷痛苦[3]。在本次研究中，選取2010年1月至2015年5月期間來我院接受治療的可疑前列腺癌患者300例，分析并探討經(jīng)直腸超聲造影輔助前列腺穿刺活檢與前列腺系統(tǒng)穿刺活檢的差異?！?br>