经会阴与经直肠超声引导下前列腺活检在检测临床显著和非显著前列腺癌中的应用：一项前瞻性随机对照试验

[Transperineal versus transrectal ultrasound-guided prostate biopsy in detection of clinically significant and insignificant prostate cancer: A prospective randomized controlled trial].

作者信息

Liu Wei-Yong, Wang Tao, Ma Dan-Dan, Wang Peng

机构信息

Department of Ultrasound, Anhui Provincial Hospital / The First Hospital Affiliated to University of Science and Technology of China, Hefei, Anhui 230001, China.

Department of Radiology, Anhui Provincial Hospital / The First Hospital Affiliated to University of Science and Technology of China, Hefei, Anhui 230001, China.

出版信息

Zhonghua Nan Ke Xue. 2024 Jan;30(1):26-31.

PMID:39046410

Abstract

OBJECTIVE

To compare transperineal prostate biopsy (TPB) with transrectal ultrasound-guided prostate biopsy (TRUSB) in detection of clinically significant prostate cancer (csPCa) and insignificant PCa (insPCa).

METHODS

We conducted a prospective randomized clinical study on 279 patients receiving TPB (n = 144) or TRUSB (n = 135) from January 2022 to January 2023, and compared the detection rates of csPCa and insPCa between the two groups.

RESULTS

The detection rate of PCa was significantly higher in the TPB than in the TRUSB group (37.50% vs 28.15%, P = 0.026). There were no statistically significant differences between the TPB and TRUSB groups in the detection rates of insPCa (6.94% ［n = 10］ vs 4.45% ［n = 6］, P > 0.05) and csPCa (30.56% ［n = 44］ vs 23.70% ［n = 32］, P > 0.05), nor in the detection rate of csPCa between different groups of age, PSA concentration and prostate volume (P > 0.05). No statistically significant differences were observed between the TPB and TRUSB groups either in the positive rate of biopsy punctures (［16.44 ± 2.86］% vs ［12.48 ± 2.39］%, P > 0.05) or in the biopsy-related complications of urinary retention, urinary tract infection, hematuria and rectal bleeding (P > 0.05).

CONCLUSION

TPB is more effective than TRUSB in detection of PCa, but there is no statistically significant difference between the two approaches in the detection rates of csPCa and insPCa.

摘要

目的

比较经会阴前列腺穿刺活检（TPB）与经直肠超声引导下前列腺穿刺活检（TRUSB）在检测临床显著性前列腺癌（csPCa）和非显著性前列腺癌（insPCa）方面的差异。

方法

我们于2022年1月至2023年1月对279例接受TPB（n = 144）或TRUSB（n = 135）的患者进行了一项前瞻性随机临床研究，并比较了两组之间csPCa和insPCa的检出率。

结果

TPB组的前列腺癌检出率显著高于TRUSB组（37.50%对28.15%，P = 0.026）。TPB组和TRUSB组在insPCa检出率（6.94% ［n = 10］对4.45% ［n = 6］，P > 0.05）和csPCa检出率（30.56% ［n = 44］对23.70% ［n = 32］，P > 0.05）方面无统计学显著差异，在不同年龄、PSA浓度和前列腺体积组之间的csPCa检出率也无统计学显著差异（P > 0.05）。TPB组和TRUSB组在活检穿刺阳性率（［16.44 ± 2.86］%对［12.48 ± 2.39］%，P > 0.05）或与活检相关的尿潴留、尿路感染、血尿和直肠出血并发症方面也未观察到统计学显著差异（P > 0.05）。