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经会阴模板定位前列腺11区饱和穿刺活检:附2066例分析

严维刚,  李汉忠,  纪志刚,  周毅,  周智恩,  崔全才

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文章导航 > 协和医学杂志  > 2012 >  3(2): 190-194
严维刚, 李汉忠, 纪志刚, 周毅, 周智恩, 崔全才. 经会阴模板定位前列腺11区饱和穿刺活检:附2066例分析[J]. 协和医学杂志, 2012, 3(2): 190-194. doi: 10.3969/j.issn.1674-9081.2012.02.013
引用本文: 严维刚, 李汉忠, 纪志刚, 周毅, 周智恩, 崔全才. 经会阴模板定位前列腺11区饱和穿刺活检:附2066例分析[J]. 协和医学杂志, 2012, 3(2): 190-194. doi: 10.3969/j.issn.1674-9081.2012.02.013
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Wei-gang YAN, Han-zhong LI, Zhi-gang JI, Yi ZHOU, Zhi-en ZHOU, Quan-cai CUI. Transperineal Ultrasound Guided Template Saturation Prostate Biopsy: Report of 2066 Cases[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(2): 190-194. doi: 10.3969/j.issn.1674-9081.2012.02.013
Citation: Wei-gang YAN, Han-zhong LI, Zhi-gang JI, Yi ZHOU, Zhi-en ZHOU, Quan-cai CUI. Transperineal Ultrasound Guided Template Saturation Prostate Biopsy: Report of 2066 Cases[J]. Medical Journal of Peking Union Medical College Hospital, 2012, 3(2): 190-194. doi: 10.3969/j.issn.1674-9081.2012.02.013
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经会阴模板定位前列腺11区饱和穿刺活检:附2066例分析

doi: 10.3969/j.issn.1674-9081.2012.02.013
  • 1.

    中国医学科学院 北京协和医学院 北京协和医院 泌尿外科 , 北京 100730

  • 2.

    中国医学科学院 北京协和医学院 北京协和医院 病理科, 北京 100730

基金项目: 

中央保健局基金 B2009B091

详细信息
    通讯作者:

    李汉忠 电话:010-69156035, E-mail:lihanzhong@medmail.com.cn

  • 中图分类号: R737.25;R446.8

Transperineal Ultrasound Guided Template Saturation Prostate Biopsy: Report of 2066 Cases

  • 1.

    Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

  • 2.

    Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

More Information

    摘要
  • 摘要:   目的  探讨经直肠超声引导下经会阴模板定位前列腺饱和穿刺活检的准确性与安全性。  方法  选择北京协和医院2066例前列腺特异性抗原(prostate specific antigen, PSA) > 4.0 ng/ml和/或直肠指检异常和/或前列腺B超、CT或MRI异常者接受饱和穿刺活检, 根据前列腺解剖特点, 分11区穿刺活检。患者年龄26~92岁, 平均70.2岁; PSA 0.2~5000 ng/ml, 中位数11.7 ng/ml; 前列腺体积7~450 ml, 中位数45.0 ml。  结果  每区活检1~4针, 共11~44针, 平均18.7针。前列腺癌活检阳性率39.3%(812/2066), PSA 0~4.0、4.1~10.0、10.1~20.0、20.1~50.0、50.1~100.0及 > 100.1 ng/ml活检者阳性率分别为24.1%(28/116)、18.9%(140/739)、30.4%(192/631)、56.3%(148/263)、84.5%(130/142)及99.4%(174/175)。术后血尿发生率为38.0%(785/2066), 急性尿潴留2.1%(42/2066), 感染性休克0.05%(1/2066)。全组无死亡病例。  结论  经直肠超声引导下经会阴模板定位饱和穿刺活检精确而安全, 对于早期前列腺癌的准确分期及治疗方案选择有重要意义。
    Abstract:   Objective  To assess the efficacy and safety of transperineal ultrasound guided template saturation prostate biopsy.  Methods  In a prospective study, a total of 2066 patients (26-92 years old, mean:70.2 years) who met the inclusion criteria underwent transperineal ultrasound guided saturation prostate biopsy using an 11-region template. The inclusion criteria included:a prostate specific antigen (PSA) level of 4.0 ng/ml or greater and abnormal prostate gland findings on digital rectal examination, ultrasound, CT, and/or MRI. Of these 2066 patients, the median PSA level was 11.7 ng/ml (range:0.2-5000 ng/ml) and the median prostate volume was 45.0 ml (range:7-450 ml).  Results  Prostate cancer was detected in 812 of 2066 patients (39.3%). The prostate cancer detection rates in groups with PSA 0-4.0, 4.1-10.0, 10.1-20.0, 20.1-50.0, 50.1-100.0, and > 100.1 ng/ml groups were 24.1% (28/116), 18.9% (140/739), 30.4% (192/631), 56.3% (148/263), 84.5% (130/142), and 99.4% (174/175), respectively. Among all these 2066 patients, 785 (38.0%) had mild and transient (1 to 7 days) hematuria, 42 (2.1%) had urinary retention, and 1 (0.05%) had septic shock postoperatively. No patient died during the procedure.  Conclusion  Transperineal ultrasound guided template saturation prostate biopsy is a safe and accurate procedure and can be useful for the precise TNM staging and the treatment decision-making.
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  • 图  1  用于前列腺穿刺活检的定位模板及穿刺针

    下载: 全尺寸图片 幻灯片

    图  2  前列腺横纵切面各区分布示意图

    1区:右前区; 2区:右中外区; 3区:右中区; 4区:右后外侧角区; 5区:右后区; 6区:左后区; 7区:左后外侧角区; 8区:左中区; 9区:左中外区; 10区:左前区; 11区:前列腺尖部

    下载: 全尺寸图片 幻灯片

    图  3  两种不同前列腺穿刺途径示意图

    下载: 全尺寸图片 幻灯片
    • 参考文献(20)
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  • 收稿日期:  2012-01-29
  • 刊出日期:  2012-04-30

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