十次系统经直肠超声引导下前列腺穿刺活检的诊断价值
Diagnostic value of ten systematic TRUS-guided prostate biopsies.
作者信息
Ravery V, Billebaud T, Toublanc M, Boccon-Gibod L, Hermieu J F, Moulinier F, Blanc E, Delmas V, Boccon-Gibod L
机构信息
Department of Urology, Bichat-Claude Bernard Hospital, Paris, France.
出版信息
Eur Urol. 1999 Apr;35(4):298-303. doi: 10.1159/000019866.
OBJECTIVE
To evaluate the improvement in the rate of detection of prostate cancer using an extensive protocol involving ten transrectal biopsies.
METHODS
A total of 162 patients submitted to transrectal ultrasound-guided biopsy for elevated prostate-specific antigen (PSA) and/or abnormality on digital rectal examination were studied consecutively and prospectively. Five biopsies were performed in each lobe: between the three standard biopsies on each side, two additional biopsy specimens were taken in the same plane and at the same 45 degrees angle.
RESULTS
The complication rate with the ten-biopsy protocol was 1.85%. Prostate cancer was detected in 40.1% of the patients. In the overall series, the percentage of diagnostic improvement brought about by this ten-biopsy protocol was +3.1%. The percentage improvement was greatest (+4.9%) in patients with PSA </=10 ng/ml.
CONCLUSION
Increasing the number of biopsy cores without altering the angle of biopsy and/or the zone sampled does not lead to a significant improvement in the detection of prostate cancer.
目的
采用包含十次经直肠活检的广泛方案评估前列腺癌检出率的提高情况。
方法
对总共162例因前列腺特异性抗原（PSA）升高和/或直肠指检异常而接受经直肠超声引导活检的患者进行连续前瞻性研究。每个叶进行五次活检：在每侧三次标准活检之间，在同一平面以相同的45度角再取两个活检标本。
结果
十次活检方案的并发症发生率为1.85%。40.1%的患者检测出前列腺癌。在整个系列中，该十次活检方案带来的诊断改善百分比为+3.1%。在PSA≤10 ng/ml的患者中改善百分比最大（+4.9%）。
结论
在不改变活检角度和/或取样区域的情况下增加活检芯数量并不能显著提高前列腺癌的检出率。
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