摘要/Abstract
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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