【摘要】 目的　探讨B超引导下前列腺穿刺筛查前列腺癌的临床意义。　方法　采用 6针系统活检加结节处 2～ 4针活检 ,197例前列腺特异抗原 (PSA) >4ng/ml或有前列腺结节的患者行超声引导下前列腺穿刺活检 ,对 4例PSA持续升高者行重复穿刺。　结果　有结节者 10 7例中发现前列腺癌 34例 (31.8% ) ,90例无结节者中发现前列腺癌 11例 (12 .2 % )。分析显示 :PSA越高 ,穿刺活检阳性率越高。重复穿刺者 4例中发现前列腺癌 1例。　结论　对有前列腺结节或PSA >4ng/ml的前列腺增生患者应行系统活检以筛查前列腺癌 ,穿刺阴性后如PSA持续增高则应重复穿刺。更多还原

【Abstract】 Objective To investigate the clinical significance of ultrasound guided systematic biopsy in detecting prostate cancer in patients with PSA>4 ng/ml and/or with prostate nodule found on DRE or TRUS . Methods 197 patients suspected of prostate carcinoma underwent ultrasound guided sextant biopsy and 2～4 more cores in the nodule. Four patients whose initial biopsy was negative but subsequent PSA levels were continuously abnormal underwent repeated biopsies. Results Of the 107 cases with prostate nodules,in 34(31.8%) of them prostate cancer was detected,while in 90 cases without a prostate nodule, only 11(12.2%) were positive. Stratified analysis on PSA found that the higher the PSA, the higher the positive biopsy rate of prostate carcinoma. In the 4 cases with repeated biopsies, 1 prostate cancer was detected. Conclusions For patients with prostate nodule and/or PSA over 4 ng/ml,systematic biopsy should be taken, with 2 or more cores toward the nodule.In the patients with continuous high PSA levels,if the first biopsy is negative, rebiopsy should be taken.更多还原