Department of Ultrasound, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Department of Urology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
World J Surg Oncol. 2019 Feb 13;17(1):31. doi: 10.1186/s12957-019-1573-0.
Because conventional prostate biopsy has some limitations, optimal variations of prostate biopsy strategies have emerged to improve the diagnosis rate of prostate cancer. We conducted the systematic review to compare the diagnosis rate and complications of transperineal versus transrectal prostate biopsy. We searched for online publications published through June 27, 2018, in PubMed, Scopus, Web of Science, and Chinese National Knowledge Infrastructure databases. The relative risk and 95% confidence interval were utilized to appraise the diagnosis and complication rate. The condensed relative risk of 11 included studies indicated that transperineal prostate biopsy has the same diagnosis accuracy of transrectal prostate biopsy; however, a significantly lower risk of fever and rectal bleeding was reported for transperineal prostate biopsy. No clue of publication bias could be identified.
To conclude, this review indicated that transperineal and transrectal prostate biopsy have the same diagnosis accuracy, but the transperineal approach has a lower risk of fever and rectal bleeding. More studies are warranted to confirm these findings and discover a more effective diagnosis method for prostate cancer.
由于传统的前列腺活检存在一些局限性，因此出现了优化的前列腺活检策略变化，以提高前列腺癌的诊断率。我们进行了系统评价，以比较经会阴和经直肠前列腺活检的诊断率和并发症。我们在 PubMed、Scopus、Web of Science 和中国国家知识基础设施数据库中检索了截至 2018 年 6 月 27 日发表的在线出版物。利用相对风险和 95%置信区间评估诊断和并发症发生率。11 项纳入研究的浓缩相对风险表明，经会阴前列腺活检与经直肠前列腺活检具有相同的诊断准确性；然而，经会阴前列腺活检报告的发热和直肠出血风险显著较低。未发现发表偏倚的迹象。
总之，本综述表明经会阴和经直肠前列腺活检具有相同的诊断准确性，但经会阴入路的发热和直肠出血风险较低。需要更多的研究来证实这些发现，并发现更有效的前列腺癌诊断方法。
