【摘要】 目的比较经直肠超声(TRUS)引导下经会阴与经直肠穿刺活检诊断前列腺癌的价值。方法将111例临床疑似前列腺癌患者随机分为经会阴组56例与经直肠组55例,分别在TRUS引导下行经会阴与经直肠系统性穿刺活检,每例8~9针,比较两组诊断前列腺癌的阳性率及Gleason评分。结果经会阴组获取的标本长度为(15.75±2.54)mm,长于经直肠组的(14.40±2.62)mm(P<0.05)。经会阴组诊断前列腺癌的阳性率为42.86%,高于经直肠组的34.55%(P<0.05);经会阴组单针穿刺诊断前列腺癌阳性率为26.77%,高于经直肠组的19.32%(P<0.05)。在206份阳性标本中,前列腺周缘区169份(82.04%),前列腺前区37份(17.96%)。两组间Gleason评分比较,差异无统计学意义(P>0.05)。结论 TRUS引导下经会阴前列腺穿刺活检较经直肠穿刺活检准确性更高。更多还原

【Abstract】 Objective To compare the value of transperineal biopsy with transrectal biopsy guided by transrectal ultrasound( TRUS) for the diagnosis of prostatic cancer. Methods A total of 111 patients clinically suspected as prostatic cancer were randomly divided into transperineal group( n = 56) and transrectal group( n = 55). The transperineal group and transrectal group underwent transperineal and transrectal prostate biopsy guided by TRUS respectively,and 8- 9 cores were performed in each case. The positive diagnostic rate for prostatic cancer and Gleason score were compared between two groups. Results The length of the specimens in the transperineal group was longer than that in the transrectal group[( 15. 75 ± 2. 54) mm vs.( 14. 40 ± 2. 62) mm,P < 0. 05]. The positive diagnostic rate for prostate cancer in the transperineal group was higher than that in the transrectal group( 42. 86% vs. 34. 55%,P < 0. 05). The positive diagnostic rate of single core for prostate cancer in the transperineal group was higher than that in the transrectal group( 26. 77% vs. 19. 32%,P < 0. 05). Of 206 positive specimens,169 were located in the peripheral zone of prostate( 82. 04%),and 37 in anterior region of prostate( 17. 96%). There was no significant difference in the Gleason score between two groups( P > 0. 05). Conclusion TRUS-guided transperineal prostate biopsy is more accurate compared to TRUS-guided transrectal biopsy.更多还原