洪睿霞,李芳.经直肠与经会阴途径穿刺活检诊断前列腺癌的对比分析[J].中国介入影像与治疗学,2019,16(9):555-559
经直肠与经会阴途径穿刺活检诊断前列腺癌的对比分析
Comparative analysis of transrectal and transperineal biopsy in diagnosis of prostate cancer
投稿时间:2019-04-03  修订日期:2019-07-14
DOI:10.13929/j.1672-8475.201904005
中文关键词:  前列腺肿瘤  活组织检查  超声检查,介入性
英文关键词:prostatic neoplasms  biopsy  ultrasonography, interventional
基金项目:国家癌症中心攀登基金临床研究课题(NCC201822B75)。
作者单位E-mail
洪睿霞 重庆大学附属肿瘤医院 重庆市肿瘤研究所 重庆市肿瘤医院超声医学科, 重庆 400030  
李芳 重庆大学附属肿瘤医院 重庆市肿瘤研究所 重庆市肿瘤医院超声医学科, 重庆 400030 1768308607@qq.com 
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中文摘要:
      目的 比较经直肠途径与经会阴途径穿刺活检对前列腺癌(PCa)的检出率。方法 回顾性收集128例首次确诊的PCa患者,根据活检途径不同,分为经直肠途径组62例和经会阴途径组66例,比较2种途径诊断不同总前列腺特异性抗原(TPSA)水平PCa及临床意义前列腺癌(CsPCa)检出率的差异。对其中104例(经直肠途径组42例,经会阴途径组62例)在常规超声检查基础上行CEUS,于83例(经直肠途径组28例,经会阴途径组55例)检出阳性病灶后行靶向穿刺,比较2组系统穿刺及靶向穿刺PCa、CsPCa的检出率。结果 经直肠途径组PCa检出率为35.48%(22/62),CsPCa检出率为25.81%(16/62);经会阴途径组PCa检出率为42.42%(28/66),CsPCa检出率为28.79%(19/66),差异均无统计学意义(P=0.471、0.676);2组对不同TPSA水平PCa及CsPCa的检出率差异均无统计学意义(P均>0.05)。经直肠途径组与经会阴途径组在系统穿刺中PCa检出率[35.48%(22/62) vs 40.91%(27/66);P=0.587]、阳性针数/总针数[14.25%(106/744) vs 14.52%(115/792);P=0.879]、CsPCa检出率[25.81%(16/62) vs 28.79%(19/66);P=0.676]差异均无统计学意义;靶向穿刺活检PCa检出率[35.71%(10/28) vs 14.55%(8/55);P=0.002]、阳性针数/总针数[30.77%(24/78) vs 6.76%(10/148);P<0.001]差异有统计学意义。结论 超声引导下前列腺穿刺活检经直肠途径与经会阴途径对PCa及CsPCa检出率无差异。CEUS可引导前列腺靶向穿刺活检,穿刺操作时选择与CEUS相同的患者体位及解剖断面可提高PCa检出率。
英文摘要:
      Objective To compare the detection rate of prostate cancer (PCa) of transrectal and transperineal biopsy. Methods Totally 128 patients with first time diagnosed PCa were enrolled, including 62 patients in transrectal approach group and 66 patients in transperineal approach group. The detection rate of PCa and clinically significant prostate cancer (CsPCa) of biopsy in patients with different total prostate specific antigen (TPSA) levels were compared between two approaches. Among them, 104 cases (42 cases in transrectal approach group and 62 cases in transperineal approach group) underwent CEUS on the basis of routine ultrasound examination, while 83 cases (28 cases in transrectal approach group and 55 cases in transperineal approach group) underwent targeted puncture. The detection rate of PCa and CsPCa of systematic puncture and targeted puncture were compared between the two groups. Results The detection rate of PCa and CsPCa was 35.48% (22/62) and 25.81% (16/62) in transrectal approach group, 42.42% (28/66) and 28.79% (19/66) in transperineal approach group (P=0.471, 0.676). There was no significant difference in detection rates of PCa and CsPCa between the two approaches at different TPSA levels (all P>0.05). There was no significant difference in PCa detection rates (35.48%[22/62] vs 40.91%[27/66]; P=0.587), positive needle number/total times (14.25%[106/744] vs 14.52%[115/792]; P=0.879) nor CsPCa detection rates (25.81%[16/62] vs 28.79%[19/66]; P=0.676) between the two approaches. There were significant differences in PCa detection rates (35.71%[10/28] vs 14.55%[8/55]; P=0.002) and positive needle number/total times (30.77%[24/78] vs 6.76%[10/148]; P<0.001) between the two approaches. Conclusion There is no significant difference in the detection rate of PCa and CsPCa between transrectal and transperineal approaches in ultrasound-guided prostate biopsy. CEUS can guide targeted prostate biopsy. Choosing the same patient position and anatomical section as CEUS can improve the detection rate of prostate cancer of biopsy.
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