前列腺体积与穿刺活检阳性率和前列腺癌恶性程度的相关性

摘要

Objective:To analyze the relation of prostatic volume (PV) with positive rate of prostate biopsy and the malignant grades of prostate cancer.Methods:A total of 419 cases of prostatic cancer in our hospital from August 1998 to August 2011 were reported.In which,346 cases received transrectal ultrasound (TURS) guided prostate biopsy were analyzed with the 430 non-cancer cases at the same period that also received TRUS guided prostate biopsy.Results:There was a larger percentage of high-level PSA cases in cancer group (P ＜ 0.05).Compared with non-cancer group,there was a smaller percentage of PV ＞ 60ml cases (16.8％ vs 36.3％),larger percentage of PV ＜40ml cases (29.5％ vs 15.3％),larger percentage of positive founding cases under TURS or digital rectal examination (65.0％ vs 21.4 ％),and more prostate specific antigen density (PSAD):4.830 7ng/ml2 (0.013 5 ～ 58.107 8ng/ml2) vs 0.503 5ng/ml2 (0.015 5 ～ 12.850 1ng/ml2) in cancer group.There were differences in the percentage of cases between PV ＞ 60ml and PV ＜ 60ml in cancer group that divided by various Gleason scores (P ＜ 0.05).Conclusion:PV has negative relationship with both the positive rate of prostate biopsy and the level of malignancy of prostatic cancer.The 6-core prostate biopsy has deficiencies.%目的:分析我院确诊为前列腺癌患者的病例资料,探讨其中超声引导下经直肠前列腺穿刺活检病例的前列腺体积(PV)与穿刺阳性率和前列腺癌恶性程度的关系.方法:回顾性分析我院1998年至今诊断明确的前列腺癌共计419例,将其中346例行前列腺穿刺活检明确诊断的病例与同期430例行前列腺穿刺活检但未诊断前列腺癌的病例进行回顾性比较分析.结果:癌症组与非癌症组相比,高PSA病例较多(P＜0.05).两组中,前列腺体积大于60ml(16.8％ vs 36.3％)和PV小于40ml(29.5％ vs 15.3％)的病例比较,差异有统计学意义.经直肠指检或经直肠超声检查有阳性发现的病例比差异较明显(65.0％ vs21.4％).两组间PS-AD值的差异有统计学意义:4.830 7 ng/ml2(0.013 5～58.107 8 ng/ml2) vs0.503 5 ng/ml2(0.015 5 ～12.850 1 ng/ml2).癌症病人中PV大于60ml的病例与PV小于等于60ml的病例相比,不同Gleason评分的病例相比,差异有统计学意义(P＜0.05).结论:前列腺体积与前列腺穿刺活检的阳性率呈负相关,也与前列腺癌恶性程度呈负相关.6针穿刺活检法存在一定局限性.