经会阴模板引导活检在至少两次阴性前列腺活检后用于诊断前列腺癌。
Transperineal template-guided biopsy for diagnosis of prostate cancer in patients with at least two prior negative biopsies.
机构信息
Department of Urology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
出版信息
Wien Klin Wochenschr. 2013 Nov;125(21-22):669-73. doi: 10.1007/s00508-013-0421-4. Epub 2013 Sep 24.
OBJECTIVE
To evaluate the prostate cancer (PCa) detection rate, PCa location, PCa significance and complications of a standardized 24-core template-guided transperineal biopsy (TPB) approach in patients with at least two negative transrectal biopsies.
METHODS
We prospectively recruited 50 men who had at least two negative transrectal ultrasound-guided extended biopsies in the past 24 months, a prostate-specific antigen (PSA) < 20 ng/mL, a prostate volume < 100 mL, and life expectancy of at least 90 % at 10 years. All patients underwent a standardized 24-core template-guided TPB biopsy. The PCa detection rate, PCa location, PCa significance, and complications were recorded.
RESULTS
Median age was 57.5 years and the median PSA level was 7.3 ng/ml. PCa was detected in 24 patients (48 %). The anterior zone was involved in 16 (32 %) PCa. Six PCa (25 %) were insignificant. Biopsy related complications occurred in 2 patients (4 %).
CONCLUSIONS
A 24-core TPB is a safe procedure with a high PCa detection rate. Few of the detected PCa are clinically insignificant. Men with at least two negative transrectal biopsies may be counseled to undergo TPB.
目的
评估在至少两次经直肠超声引导扩展活检均为阴性、前列腺特异性抗原（PSA）<20ng/ml、前列腺体积<100ml、10 年预期寿命至少 90%的患者中，采用标准化 24 针经会阴模板引导前列腺穿刺活检（TPB）的前列腺癌（PCa）检出率、PCa 位置、PCa 意义和并发症。
方法
我们前瞻性招募了 50 名男性患者，他们在过去 24 个月中至少有两次经直肠超声引导扩展活检均为阴性、PSA<20ng/ml、前列腺体积<100ml、10 年预期寿命至少 90%。所有患者均接受标准化 24 针经会阴模板引导 TPB 活检。记录 PCa 检出率、PCa 位置、PCa 意义和并发症。
结果
中位年龄为 57.5 岁，中位 PSA 水平为 7.3ng/ml。24 名患者（48%）检出 PCa。16 名患者（32%）的前区受累。6 例 PCa（25%）为非显著性。2 名患者（4%）发生活检相关并发症。
结论
24 针 TPB 是一种安全的操作，具有较高的 PCa 检出率。检出的 PCa 中很少有临床意义。对于至少两次经直肠活检均为阴性的男性，可以考虑进行 TPB。
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