Slonim S M, Cuttino J T, Johnson C J, Yankaskas B C, Smith J J, Silverman M L, Libertino J A
Department of Diagnostic Radiology, Lahey Clinic, Burlington, MA 01805.
AJR Am J Roentgenol. 1993 Nov;161(5):1003-6. doi: 10.2214/ajr.161.5.8273601.
We studied the efficacy of random, transrectal sonographically guided biopsies in the diagnosis of prostatic carcinoma in a high-risk population.
During a 2-year period, 570 transrectal sonographically guided prostatic biopsies were done because of clinical findings suggestive of prostatic carcinoma. Biopsies of hypoechoic lesions that were suggestive of carcinoma and segmental random biopsies of normal-appearing lobes of the prostate were performed. Transrectal sonographic findings were correlated with results of pathologic examination of the biopsy specimen and with surgical results, when available.
Of the 202 patients found to have carcinoma, the carcinoma was detected with directed biopsy in 145 patients (72%). One hundred twenty (71%) of 169 carcinomas were detected with random biopsy when that procedure was performed. Random biopsies were the only method of diagnosing 57 (28%) of the 202 carcinomas, increasing the yield by 39%.
Yield of carcinoma on transrectal sonographically guided biopsies increases significantly when segmental random biopsies are performed. Transrectal sonographically guided biopsies should include cores through hypoechoic lesions that are suggestive of carcinoma and bilateral segmental random biopsies.
我们研究了在高危人群中，经直肠超声引导下随机活检在前列腺癌诊断中的有效性。
在两年期间，因临床发现提示前列腺癌而进行了570次经直肠超声引导下的前列腺活检。对提示癌的低回声病变以及外观正常的前列腺叶进行分段随机活检。将经直肠超声检查结果与活检标本的病理检查结果以及手术结果（若有）进行关联分析。
在202例被发现患有癌症的患者中，145例（72%）通过靶向活检检测到癌症。在进行随机活检时，169例癌症中有120例（71%）被检测到。随机活检是诊断202例癌症中57例（28%）的唯一方法，使检出率提高了39%。
当进行分段随机活检时，经直肠超声引导下活检的癌症检出率显著提高。经直肠超声引导下活检应包括取自提示癌的低回声病变以及双侧分段随机活检的组织条。
