中国男科学杂志
中國男科學雜誌
중국남과학잡지
CHINESE JOURNAL OF ANDROLOGY
2014年
5期
29-33
,共5页
李伟%陈跃东%张开颜%段波%郑嘉欣%邢金春
李偉%陳躍東%張開顏%段波%鄭嘉訢%邢金春
리위%진약동%장개안%단파%정가흔%형금춘
前列腺肿瘤/超声检查%活组织检查, 针吸
前列腺腫瘤/超聲檢查%活組織檢查, 針吸
전렬선종류/초성검사%활조직검사, 침흡
prostatic neoplasms/ultrasonography%biopsy,needle
目的：探讨PSA水平、PSA密度（PSAD）、前列腺体积对B超引导下的前列腺外侧方活检阳性率的影响。方法2005年1月至2010年1月，671例PSA在4~20ng/mL之间的患者接受了B超引导下的前列腺系统穿刺活检（大于或等于10点前列腺穿刺活检）。均资料齐全患者纳入本研究。以系统性6针前列腺穿刺活结果与系统性10针前列腺穿刺活检结果比较。所有入组患者根据PSA水平、PSAD、前列腺体积进行进一步划分。计量资料采用t 检验，计数资料采用McNemar检验和Fisher’s 精确概率法进行统计，采用SPSS19统计学软件包进行统计分析。结果系统10针穿刺和系统6针穿刺总穿刺阳性率分别为22.8%和20.0%。与6针穿刺活检相比较，10针穿刺活检可额外发现19例前列腺癌（19/153，12.4%）（P＜0.05）。PSA水平在4~20ng/mL之间且前列腺体积小于等于40mL时，10针和6针穿刺阳性率分别为28.0%和23.8%，10针穿刺活检可额外发现15例前列腺癌（15/98，15.3%）（P ＜0.05）。PSA水平在4~20ng/mL之间且PSAD大于0.15时，10针和6针穿刺阳性率分别为28.3%和14.5%，10针穿刺活检可额外发现17例前列腺癌（17/129，13.3%）（P ＜0.05）。PSA水平在4~10ng/mL之间时，10针和6针穿刺阳性率分别为19.4%和16.1%，10针穿刺活检可额外发现16例前列腺癌（16/94，17.0%）（P＜0.05）。PSA水平在4~10ng/mL之间且前列腺体积小于等于40mL时，10针和6针穿刺阳性率分别为24.2%和19.2%，10针穿刺活检可额外发现14例前列腺癌（14/68，20.6%）（P＜0.05）。PSA水平在4~10ng/mL之间且PSAD大于0.15时，10针和6针穿刺阳性率分别为24.1%和19.3%，10针穿刺活检可额外发现14例前列腺癌（14/70，20.0%）（P＜0.05）。PSA水平在10~20ng/mL之间时，10针和6针穿刺阳性率分别为31.6%和29.9%，10针穿刺活检可额外发现3例前列腺癌（3/59，5.1%）（P＞0.05）。PSA水平在10~20ng/mL之间且前列腺体积≤40mL时，10针和6针穿刺阳性率分别为41.7%和40.3%，10针穿刺活检可额外发现1例前列腺癌（1/30，3.4%）（P＞0.05）。PSA水平在10~20ng/mL之间且PSAD大于0.15时，10针和6针穿刺阳性率分别为40.0%和34.1%，10针穿刺活检可额外发现3例前列腺癌（3/59，5.1%）（P＞0.05）。结论10针前列腺穿刺活检阳性率明显高于6针穿刺。B超引导下的前列腺外侧方活检可额外发现6针穿刺漏诊的前列腺癌。PSA水平、PSAD、前列腺体积是影响B超引导下前列腺外侧方活检的因素。
目的：探討PSA水平、PSA密度（PSAD）、前列腺體積對B超引導下的前列腺外側方活檢暘性率的影響。方法2005年1月至2010年1月，671例PSA在4~20ng/mL之間的患者接受瞭B超引導下的前列腺繫統穿刺活檢（大于或等于10點前列腺穿刺活檢）。均資料齊全患者納入本研究。以繫統性6針前列腺穿刺活結果與繫統性10針前列腺穿刺活檢結果比較。所有入組患者根據PSA水平、PSAD、前列腺體積進行進一步劃分。計量資料採用t 檢驗，計數資料採用McNemar檢驗和Fisher’s 精確概率法進行統計，採用SPSS19統計學軟件包進行統計分析。結果繫統10針穿刺和繫統6針穿刺總穿刺暘性率分彆為22.8%和20.0%。與6針穿刺活檢相比較，10針穿刺活檢可額外髮現19例前列腺癌（19/153，12.4%）（P＜0.05）。PSA水平在4~20ng/mL之間且前列腺體積小于等于40mL時，10針和6針穿刺暘性率分彆為28.0%和23.8%，10針穿刺活檢可額外髮現15例前列腺癌（15/98，15.3%）（P ＜0.05）。PSA水平在4~20ng/mL之間且PSAD大于0.15時，10針和6針穿刺暘性率分彆為28.3%和14.5%，10針穿刺活檢可額外髮現17例前列腺癌（17/129，13.3%）（P ＜0.05）。PSA水平在4~10ng/mL之間時，10針和6針穿刺暘性率分彆為19.4%和16.1%，10針穿刺活檢可額外髮現16例前列腺癌（16/94，17.0%）（P＜0.05）。PSA水平在4~10ng/mL之間且前列腺體積小于等于40mL時，10針和6針穿刺暘性率分彆為24.2%和19.2%，10針穿刺活檢可額外髮現14例前列腺癌（14/68，20.6%）（P＜0.05）。PSA水平在4~10ng/mL之間且PSAD大于0.15時，10針和6針穿刺暘性率分彆為24.1%和19.3%，10針穿刺活檢可額外髮現14例前列腺癌（14/70，20.0%）（P＜0.05）。PSA水平在10~20ng/mL之間時，10針和6針穿刺暘性率分彆為31.6%和29.9%，10針穿刺活檢可額外髮現3例前列腺癌（3/59，5.1%）（P＞0.05）。PSA水平在10~20ng/mL之間且前列腺體積≤40mL時，10針和6針穿刺暘性率分彆為41.7%和40.3%，10針穿刺活檢可額外髮現1例前列腺癌（1/30，3.4%）（P＞0.05）。PSA水平在10~20ng/mL之間且PSAD大于0.15時，10針和6針穿刺暘性率分彆為40.0%和34.1%，10針穿刺活檢可額外髮現3例前列腺癌（3/59，5.1%）（P＞0.05）。結論10針前列腺穿刺活檢暘性率明顯高于6針穿刺。B超引導下的前列腺外側方活檢可額外髮現6針穿刺漏診的前列腺癌。PSA水平、PSAD、前列腺體積是影響B超引導下前列腺外側方活檢的因素。
목적：탐토PSA수평、PSA밀도（PSAD）、전렬선체적대B초인도하적전렬선외측방활검양성솔적영향。방법2005년1월지2010년1월，671례PSA재4~20ng/mL지간적환자접수료B초인도하적전렬선계통천자활검（대우혹등우10점전렬선천자활검）。균자료제전환자납입본연구。이계통성6침전렬선천자활결과여계통성10침전렬선천자활검결과비교。소유입조환자근거PSA수평、PSAD、전렬선체적진행진일보화분。계량자료채용t 검험，계수자료채용McNemar검험화Fisher’s 정학개솔법진행통계，채용SPSS19통계학연건포진행통계분석。결과계통10침천자화계통6침천자총천자양성솔분별위22.8%화20.0%。여6침천자활검상비교，10침천자활검가액외발현19례전렬선암（19/153，12.4%）（P＜0.05）。PSA수평재4~20ng/mL지간차전렬선체적소우등우40mL시，10침화6침천자양성솔분별위28.0%화23.8%，10침천자활검가액외발현15례전렬선암（15/98，15.3%）（P ＜0.05）。PSA수평재4~20ng/mL지간차PSAD대우0.15시，10침화6침천자양성솔분별위28.3%화14.5%，10침천자활검가액외발현17례전렬선암（17/129，13.3%）（P ＜0.05）。PSA수평재4~10ng/mL지간시，10침화6침천자양성솔분별위19.4%화16.1%，10침천자활검가액외발현16례전렬선암（16/94，17.0%）（P＜0.05）。PSA수평재4~10ng/mL지간차전렬선체적소우등우40mL시，10침화6침천자양성솔분별위24.2%화19.2%，10침천자활검가액외발현14례전렬선암（14/68，20.6%）（P＜0.05）。PSA수평재4~10ng/mL지간차PSAD대우0.15시，10침화6침천자양성솔분별위24.1%화19.3%，10침천자활검가액외발현14례전렬선암（14/70，20.0%）（P＜0.05）。PSA수평재10~20ng/mL지간시，10침화6침천자양성솔분별위31.6%화29.9%，10침천자활검가액외발현3례전렬선암（3/59，5.1%）（P＞0.05）。PSA수평재10~20ng/mL지간차전렬선체적≤40mL시，10침화6침천자양성솔분별위41.7%화40.3%，10침천자활검가액외발현1례전렬선암（1/30，3.4%）（P＞0.05）。PSA수평재10~20ng/mL지간차PSAD대우0.15시，10침화6침천자양성솔분별위40.0%화34.1%，10침천자활검가액외발현3례전렬선암（3/59，5.1%）（P＞0.05）。결론10침전렬선천자활검양성솔명현고우6침천자。B초인도하적전렬선외측방활검가액외발현6침천자루진적전렬선암。PSA수평、PSAD、전렬선체적시영향B초인도하전렬선외측방활검적인소。
Objective To investigate influence factors for efficiency of 10-core and sextant systematic transrectal ultrasound guided (TRUS) prostate biopsy in the diagnosis of prostate cancer. Methods Clinica data of 671 patients who underwent systemic transrectal ultrasound guided (TRUS) prostate biopsy under local anesthesia by using the 10 core scheme between Janary 2005 and Janary 2013 was retrospectively analyzed. The detection rates of prostate cancer using 10-core and sextant biopsy were compared. Group A (10-cores) consisted of 671 men. Group B (6-cores) included the same group of people but only the result of sextant biopsy. Men were stratified according to biopsy protocol and PSA levels. The McNemar and Fisher's exact test were used for statistical analysis. Results The overall prostate cancer detection rates were 22.8% and 20.0% using 10-core and sextant scheme, respectively. An overall 12.4% (19/153) increasing in prostate cancer detection rate was observed in 10-core technique group. When prostate volume was below 40ml and PSA level was between 4ng/ml to 20ng/ml,prostate cancer detection rates were 28.0% and 13.8% using 10-core and sextant scheme, respectively. An overall 15.2% (15/98) increasing in prostate cancer detection rate was observed in 10-core technique group. When PSAD was over 0.15 and PSA level was between 4ng/ml to 20ng/ml,prostate cancer detection rates were 28.3% and 14.5% using 10-core and sextant scheme, respectively. An overall 13.3% (17/128) increasing in prostate cancer detection rate was observed in 10-core technique group. When PSA level was between 4ng/ml to 10ng/ml,the detection rates were 19.4% and 16.1%, extra 16 cases of prostate cancer were detected by 10-core technique. When prostate volume was below 40ml and PSA level was between 4ng/ml to 10ng/ml,prostate cancer detection rates were 24.2% and 19.2% using 10-core and sextant scheme, respectively. An overall 20.6% (14/68) increasing in prostate cancer detection rate was observed in 10-core technique group. When PSAD was over 0.15 and PSA level was between 4ng/ml to 10ng/ml,prostate cancer detection rates were 24.1% and 19.3% using 10-core and sextant scheme, respectively. An overall 20% (14/70) increasing in prostate cancer detection rate was observed in 10-core technique group. When PSA level was between 10ng/ml to 20 ng/ml,prostate cancer detection rates were 31.6% and 29.9% respectively, 3 cases were undetected using 6-core technique but detected using 10-core technique. When prostate volume was below 40ml and PSA level was between 10ng/ml to 20ng/ml,prostate cancer detection rates were 41.7%and 40.3% using 10-core and sextant scheme, respectively. An overall 3.4% (1/30) increasing in prostate cancer detection rate was observed in 10-core technique group. When PSAD was over 0.15 and PSA level was between 10ng/ml to 20ng/ml, prostate cancer detection rates were 40.0% and 34.1% using 10-core and sextant scheme, respectively. An overall 5.1% (3/59) increasing in prostate cancer detection rate was observed in 10-core technique group. Conclusion Cancer detection rate using 10-core scheme was higher than that using sextant biopsy . 10-core scheme showed best efficiency in cancer detection rate. PSA level, PSAD and prostate volume might influence the efficiency of prostate biopsy guided by systematic transrectal ultrasound.
