徒手和超声引导经直肠前列腺穿刺活检术两种方法讨论(1)
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[摘要] 目的：讨论徒手和超声引导经直肠前列腺穿刺活检术两种方法的意义。方法：一种为对可疑前列腺癌(PCA)39例患者行徒手经直肠穿刺前列腺左右两侧叶共6点送病理检查，另一种对可疑前列腺癌63例患者依据TRUS选择穿刺点(均为左右两侧叶共6点)行经直肠前列腺穿刺活检(声像图检查有可疑PCA 结节，则在该处穿刺1～2针(常规底部+中部+尖部+超声可疑点)。如果声像图无明确病灶，则分别在前列腺的双侧底、中、尖部穿刺6针，穿刺标本完全满足组织学检查的要求。结果：A组39例，平均年龄 71.4 岁；B组63例，平均年龄72.3岁。直肠指检发现前列腺结节数A组4例，B组2例；两组穿刺取材良好，均获得病理结果。共检出前列腺癌20例，A组6例，B组14例，检出率分别为 15.38%和 22.22%。A组中有2例漏诊，B组中无1例漏诊，B本组有2例仅1个穿刺点有癌组织，为直径仅5 mm的前列腺单发微小癌瘤。A组中39例均未能检查出前列腺上皮内瘤(PIN)，B组中有PINⅠ 3例，PIN Ⅱ 2例。A组中6例均为中晚期患者，B组8例为早期患者，6例为中晚期患者。结论：依据TRUS定位行前列腺穿刺活检较徒手行前列腺穿刺活检，能提高PCA检出率，减少并发症，达到早期诊断、早期治疗的目的。
[关键词] 前列腺癌；徒手及TURS穿刺；直肠；活检
[中图分类号] R392.31 [文献标识码] A [文章编号] 1674-4721(2011)11(c)-023-03
Two methods to discuss the unarmed and by transrectal ultrasound guidance prostate biopsy approaches
XIE Wenfeng, PAN Jie, HUANG Limei, WU Junyan, DENG Ziliang
Department of Urology, the Yingde People′s Hospital of Guangdong Province, Yingde 513000, China
[Abstract] Objective: To discuss the unarmed and by transrectal ultrasound guidance prostate biopsy approaches two methods significance. Methods: A for suspected for prostate cancer (PCA) and patients did by transrectal prostate biopsy unarmed left or right side of 6, send pathological examination, another kind of suspected prostate cancer 63 patients TRUS chose according to puncture point (both for both sides were about 6), through prostate biopsy (rectum ultrasonographic examination the suspicious PCA nodules, was in the puncture 1-2 needle (conventional bottom+central+Tip of the prostate+Ultrasound doubt piont). If no specific ultrasonographic lesions, respectively of the prostate gland in bilateral bottom, in tip of the needle biopsy specimens, puncture 6 fully meet the requirements of the histological examination. Results: A group of 39 cases, average age 71.4 years old; B group of 43 cases, average age 72.3 years old. The rectum refers to examines the discovery prostate gland tubercle several A groups of 4 cases, B group of 2 cases; Two group of puncture selections were good, obtains the pathology result ......
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