前列腺靶向穿刺联合减区域系统穿刺法的可行性分析

胡萍; 潘俊; 王昭辉; 阳宇; 陈志远; 周懂晶; 白遵光; 陈志强

doi:10.13201/j.issn.1001-1420.2021.07.006

前列腺靶向穿刺联合减区域系统穿刺法的可行性分析

- 1. 广州中医药大学第二附属医院泌尿外科(广州, 510120);
- 2. 广州中医药大学第二附属医院病理科;
- 3. 广州中医药大学第二附属医院影像科

详细信息

通讯作者: 陈志强,E-mail:zhi57@163.com

中图分类号: R697

收稿日期: 2021-01-05

Feasibility analysis of targeted prostate biopsy combined with systematic biopsy with omitting part of the region

- 1. Department of Urology, Guangdong Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, 510120, China;
- 2. Department of Pathology, Guangdong Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine;
- 3. Department of Imaging, Guangdong Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine

More Information

Corresponding author: CHEN Zhiqiang, E-mail: zhi57@163.com

Received Date: 05 January 2021

摘要

摘要: 目的:探讨前列腺靶向穿刺联合减区域系统穿刺法的可行性。方法:纳入2016年10月—2020年6月单中心多序列磁共振(multiparametric magnetic resonance imaging,mpMRI)提示病灶位于单侧叶、总前列腺特异抗原＜20 ng/mL、接受靶向穿刺(targeted biopsy,TB)联合系统穿刺(systematic biopsy,SB)的患者103例,以联合穿刺为基准,回顾性分析TB联合减区域SB对于前列腺癌(PCa)及临床有意义前列腺癌(clinically significantprostate cancer,csPCa)检出率的敏感性。结果:TB联合SB整体阳性率48.5%(50/103),csPCa检出率38.8%(40/103);TB联合病灶同侧叶系统穿刺(ipsilaterasystematic biopsies,ipsi-SB)阳性率、csPCa检出率分别为44.7%(46/103)和35.9%(37/103),敏感性分别为92.0%(46/50)和92.5%(37/40);TB联合省略距离病灶最远区域的系统穿刺(SB with omit the farthest region from the lesion,OFR-SB)阳性率、csPCa检出率分别为46.6%(48/103)和37.9%(39/103),敏感性分别为96.0%(48/50)和97.5%(39/40)。纳入病例中穿刺病理中双侧叶阳性13例,提示省略病灶对侧叶系统穿刺除漏诊4例外,还有26.0%(13/50)的阳性患者穿刺后病理分期从T_2c降至T_2a~b,而省略距离病灶最远区域系统穿刺除2例漏诊外,病理降期的比例仅为4.0%(2/50)。结论:对于mpMRI单侧叶病灶患者,TB联合减区域SB(相对于联合穿刺)的阳性率及csPCa检出率的敏感性均较高;与TB+ipsi-SB相比,TB+OFR-SB对穿刺病理降期的影响更小(P＜0.05),更具有可行性。
- 前列腺穿刺 /
- 靶向穿刺 /
- 减区域系统穿刺
Abstract: Objective: To analyze the feasibility of targeted prostate biopsy combined with systematic biopsy with omitting part of the region.Methods: This is a cohort of 103 patients with unilateral multiparametric magnetic resonance imaging(mpMRI) lesion and total prostate-specific antigen(TPSA) ≤20 ng/mL during Oct. 2016 to Jun. 2020. All man underwent systematic biopsy(SB) and multiparametric magnetic resonance imaging and transrectal ultrasound(MRI/TRUS) fusion guided targeted biopsy(TB), which combined and were considered the standard of reference. The sensitivity of TB combined with SB with omitting part of the region for the detection rate of prostate cancer(PCa) and clinically significant prostate cancer(csPCa) were retrospectively and respectively analysed.Results: The overall detection rate of PCa and csPCa were 48.5%(50/103) and 38.8%(40/103) respectively. The detection rate of PCa and csPCa for TB combined with ipsilateral systematic biopsies(ipsi-SB) were 44.7%(46/103) and 35.9%(37/103) respectively, and sensitivity of them were 92.0%(46/50) and 92.5%(37/40). The detection rate of PCa and csPCa for TB combined with SB which omit the farthest region from the lesion(OFR-SB) were 46.6%(48/103) and 37.9%(39/103) respectively, and sensitivity of them were 96.0%(48/50) and 97.5%(39/40). Among this cohort, pathology of combined biopsy showed bilateral lesions in 13 cases. Pathological stage decreased from T_{2 c} to T_{2 a~b} of PCa in 26.0%(13/50) patients by TB+ipsi-SB except for 4 cases missed, while only 4.0%(2/50) by TB+ OFR-SB except for 2 cases missed.Conclusion: TB combined with SB with omitting part of the region have a high sensitivity in the detection rate of PCa and csPCa for patients with unilateral MRI lesion. Compared with TB+ipsi-SB, TB+OFR-SB had less effect on the decrease of pathological stage(P＜0.05), so it was more feasible.
- prostate biopsy /
- targeted prostate biopsy /
- systematic biopsy with omitting part of the region

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