超声引导下经直肠前列腺穿刺活检6针法、10针法和12针法诊断前列腺癌的临床比较

发布时间：2018-05-22 11:08

  本文选题：前列腺癌 + 穿刺活检　； 参考：《吉林大学》2014年硕士论文

【摘要】：目的：比较超声引导下经直肠前列腺6针、10针、12针法活检穿刺诊断前列腺癌的差异，并根据具体情况选择较合理的前列腺穿刺活检方案。 方法：回顾性分析研究2009年1月—2013年12月期间初步诊断为前列腺癌的病人278例，分别接受6针、10针或12针前列腺穿刺活检，其中126例患者接受6针法穿刺活检，102例接受10针法穿刺活检，50例接受12针法穿刺活检。患者年龄为43~90岁，平均71岁；PSA水平为0.1~106.1ng/ml，平均40.9ng/ml；前列腺体积为12.5~162.7ml，平均60.2ml；依照穿刺结果，对比研究6针、10针和12针穿刺法的阳性检出率。应用统计学方法对三种穿刺方案在患者年龄、PSA、前列腺体积、穿刺数量、穿刺部位及直肠检查等方面进行统计分析，并统计不同穿刺部位阳性率的差异。 结果：6针、10针、12针法穿刺的阳性率分别为42.9%（54/126）、58.8%（60/102）、62.0%（31/50）。与6针法相比，10针法和12针法分别使总体阳性率提高15.9%、19.1%，而12针法总体阳性率仅比10针法提高3.2%。10针法与6针法相比，在年龄70岁、40ml≤前列腺体积90ml、PSA40ng／ml、DRE阴性的患者中，阳性率差异更为显著，而12针法与10针法相比，，仅仅在患者前列腺体积≥90ml时，阳性率才有明显的不同。145例阳性病例共穿刺1296针，阳性针数768针，阳性率59.3%。三种方法穿刺后并发症发生率无明显差异。 结论：增加穿刺针数，前列腺癌的总体阳性率会随之提高。选择何种穿刺方法，应根据患者具体情况灵活掌握。当患者年龄70岁、PSA≤40ng/ml、40ml≤前列腺体积90ml、直肠指检阴性时，采取10针法穿刺较为适宜。当患者年龄≥70岁、PSA小于40ng/ml、前列腺体积40ml、直肠指检阳性时，采取6针法穿刺较为适宜。当患者前列腺体积≥90ml时，其他任意情况下，应采取12针法穿刺。增加穿刺针数并没有明显增加并发症的发生率。
[Abstract]:Objective: to compare the difference of transrectal prostate biopsy guided by ultrasound in diagnosis of prostate cancer with 6 or 10 or 12 needle biopsies, and to select a more reasonable prostatic biopsy scheme according to the specific conditions. Methods: a retrospective study of 278 patients with prostate cancer from January 2009 to December 2013 was performed. Among them, 126 patients received 6 needle biopsy and 102 received 10 needle biopsy and 50 received 12 needle biopsy. The age of the patients was 430.90 years old (mean 71 years old), the PSA level was 0.1 ~ 106.1 ng / ml with an average of 40.9 ng / ml, and the prostate volume was 12.5 ~ 162.7 ml, with an average of 60.2 ml. According to the puncture results, the positive rates of 10 and 12 needle puncture methods were compared and studied. Three kinds of puncture methods were used to analyze the patient's age, prostate volume, puncture quantity, puncture site and rectal examination, and the difference of positive rate among different puncture sites was analyzed. Results the positive rates of the needle puncture were 42.9%, 58.8%, 62.0% and 31 / 50, respectively. Compared with the 6 acupuncture method, the total positive rate was increased by 15. 9% and 19. 1%, respectively, while the total positive rate of 12 acupuncture method was only 3. 2% higher than that of the 10 acupuncture method. Compared with the 6 acupuncture method, the total positive rate of 12 acupuncture method was only 3. 2% higher than that of the 6 acupuncture method. In the patients aged 70 years with 40 ml 鈮

本文编号：1921811