Li Hanzhong, Yan Weigang, Zhou Yi, Ji Zhigang, Chen Jie
Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Urology. 2007 Dec;70(6):1157-61. doi: 10.1016/j.urology.2007.07.072.
To assess the prostate cancer detection rate and safety of transperineal ultrasound-guided saturation biopsies of the prostate using an 11-region template of the gland in a Chinese screening population.
A total of 303 patients (mean age, 69.7 years) were prospectively enrolled in this study to undergo an 11-region template-guided transperineal saturation biopsy of the prostate. The inclusion criteria included a prostate-specific antigen level of 4.0 ng/mL or greater, suspicious findings on the digital rectal examination, or abnormal prostate gland findings on ultrasonography, computed tomography, or magnetic resonance imaging. The median prostate-specific antigen level was 13.7 ng/mL (range, 0.2 to 100), and the median prostate volume was 47.0 cm3 (range, 7 to 190).
A mean of 23.7 cores (range, 11 to 44) were obtained, with an overall prostate cancer detection rate of 37.6% (114 of 303). The cancer detection rate in the groups with a prostate-specific antigen level of 0 to 4.0, 4.1 to 10.0, 10.1 to 20.0, 20.1 to 30.0, 30.1 to 70.0, and greater than 70.1 ng/mL was 22.2% (4 of 18), 8.2% (6 of 73), 21.6% (22 of 102), 48.4% (15 of 31), 68.4% (26 of 38), and 100% (41 of 41), respectively. No serious complications occurred during the procedure.
Transperineal ultrasound-guided saturation biopsy of the prostate is safe and feasible. Moreover, the application of an 11-region template of the prostate resulted in an encouraging cancer detection rate.
评估在中国筛查人群中,使用前列腺11区模板进行经会阴超声引导下前列腺饱和穿刺活检的前列腺癌检出率及安全性。
本研究前瞻性纳入了303例患者(平均年龄69.7岁),对其进行经会阴11区模板引导下的前列腺饱和穿刺活检。纳入标准包括前列腺特异性抗原水平为4.0 ng/mL或更高、直肠指检有可疑发现,或超声、计算机断层扫描或磁共振成像检查发现前列腺异常。前列腺特异性抗原水平中位数为13.7 ng/mL(范围0.2至100),前列腺体积中位数为47.0 cm³(范围7至190)。
平均获取23.7条组织芯(范围11至44),总体前列腺癌检出率为37.6%(303例中的114例)。前列腺特异性抗原水平为0至4.0、4.1至10.0、10.1至20.0、20.1至30.0、30.1至70.0以及大于70.1 ng/mL的组中,癌症检出率分别为22.2%(18例中的4例)、8.2%(73例中的6例)、21.6%(102例中的22例)、48.4%(31例中的15例)、68.4%(38例中的26例)和100%(41例中的41例)。操作过程中未发生严重并发症。
经会阴超声引导下前列腺饱和穿刺活检安全可行。此外,前列腺11区模板的应用带来了令人鼓舞的癌症检出率。