上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2019, Vol. 39 ›› Issue (5): 518-.doi: 10.3969/j.issn.1674-8115.2019.05.014

• 论著·临床研究 • 上一篇    下一篇

前列腺前角穿刺活检在前列腺癌诊断中的价值

谢少伟 1，董柏君 2，夏建国 1，王艳青 2，李红丽 1，张时君 1，杨文琪 1，李凤华 1   

  1. 1. 上海交通大学医学院附属仁济医院超声医学科，上海 200127；2. 上海交通大学医学院附属仁济医院泌尿科，上海 200127
  • 出版日期:2019-05-28 发布日期:2019-07-26
  • 通讯作者: 李凤华，电子信箱 :proflifh@sina.com。
  • 作者简介:谢少伟（1984—），女，主治医师，硕士；电子信箱 : shaoweixie@yeah.net。
  • 基金资助:
    上海市科学技术委员会研究项目（ 15411966300）；上海申康医院发展中心临床辅助科室能力建设项目（ SHDC22015003）；上海交通大学医学院附属仁济医院科研种子基金培养计划（RJZZ14-012）

Value of prostate anterior horn biopsy in the diagnosis of prostate cancer

XIE Shao-wei1, DONG Bai-jun2, XIA Jian-guo1, WANG Yan-qing2, LI Hong-li1, ZHANG Shi-jun1, YANG Wen-qi1, LI Feng-hua1   

  1. 1. Department of Ultrasound, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China; 2. Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2019-05-28 Published:2019-07-26
  • Supported by:
    Fund of Science and Technology Commission of Shanghai Municipality, 15411966300; Clinical Auxiliary Departments Ability Construction Project of Shanghai Hospital Development Center, SHDC22015003; Fund of Cultivating Scientific Research Seed Plan of Renji

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摘要： 目的 ·探讨前角穿刺活检在前列腺癌诊断中的临床价值。方法 ·回顾性分析 1 679例在上海交通大学医学院附属仁济医院行超声引导下经会阴 12点初次前列腺穿刺活检患者的临床及病理资料，分析比较 12点（包括前角）穿刺活检方案和 10点（除外前角）穿刺活检方案在总体及不同亚组间前列腺癌检出率的差异。结果 · 1 679例患者经穿刺诊断为前列腺癌者 678例（40.4%），仅前角阳性 59例（8.7%）。排除前角穿刺点后，穿刺阳性率为 36.9%（619/1 679），低于包含前角穿刺点的总体阳性率（ 40.4% vs 36.9%，P0.046）。在对前列腺特异性抗原（ prostate specific antigen，PSA）及前列腺体积分组比较中，对 PSA>10 ng/mL或前列腺体积≥ 30 mL的患者，采用前角穿刺后可提高穿刺阳性率（ P<0.05）。在临床特征比较中，仅前角穿刺阳性患者的前列腺体积显著高于除前角穿刺阳性患者（ P0.006），Gleason评分显著低于除前角穿刺阳性患者（ P0.000）。结论 ·增加前角穿刺能提高穿刺阳性率，推荐在初次经会阴前列腺穿刺活检中常规应用。

关键词: 前列腺癌, 穿刺活检, 前角

Abstract:

Objective · To evaluate population anterior horn biopsy in the diagnosis of prostate cancer. Methods · The clinical and pathological data of 1 679 patients who underwent ultrasound-guided initial 12-core prostate biopsies at Renji Hospital, Shanghai Jiao Tong University School of Medicine, were retrospectively analyzed. The performances of 12-core (including anterior horn) biopsy and the 10-core (except anterior horn) biopsy were compared in total population and different subgroups for the detection rates of prostate cancer. Results · Of the 1 679 patients, 678 (40.4%) were diagnosed with prostate cancer, and 59 (8.7%) were only positive at anterior horns. After excluding the anterior horn biopsy, the detection rate was 36.9% (619/1 679), which was lower than the overall detection rate including the anterior horn biopsy (40.4% vs 36.9%, P0.046). In prostate specific antigen (PSA) and prostate volume subgroups, for the patients with PSA>10 ng/mL and prostate volume ≥30 mL, the biopsy detection rate was improvedadding the anterior horn biopsy (P<0.05). The patients with only positive anterior horn biopsy had higher prostate volumes and lower Gleason scores, compared with the patients with positive biopasy excluding anterior horn (P0.006, P0.000). Conclusion · Adding the anterior horn biopsy could improve the prostate cancer detection rate, recommended to be routinely used in the initial prostate biopsies.

Key words: prostate cancer, biopsy, anterior horn

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