目的：探讨彩超引导下经直肠前列腺13+针穿刺病理结果与前列腺结节二维声像图和彩色多普勒血流显像的关系。方法应用腔内彩超对69例前列腺结节患者进行检查,观察肿块的形态、边界、内部回声，彩色多普勒血流图观察前列腺结节的血流特征。经直肠行前列腺13+针穿刺活检，将超声诊断与手术病理诊断结果进行对照。结果69例前列腺穿刺术后病理诊断为前列腺癌36例，前列腺淋巴瘤1例，前列腺不典型增生1例，前列腺增生31例。评价前列腺癌的检出率，观察血清 PSA 浓度与前列腺癌检出率之间的关系。PSA ＜4.0、4.1~10、10.1~20、20.1~30、30.1~50、50.1~100、＞100 ng/mL 各个水平中阳性率分别为21.42%、33.33%、44.44%、44.44%、71.42%、100.00%、92.30%，各组间阳性率的差异均有统计学意义（P ＜0.05）。结论13+针直肠彩超引导下前列腺穿刺活检对诊断前列腺癌具有较高的诊断价值,但需结合直肠指检与血清前列腺特异性抗原（prostate specific antigen，PSA）含量。%Objective To investigate the relationship between the results of transrectal 13+ needle biopsy and two-dimensional ultrasonography & color Doppler flow imaging (CDFI) in prostate nodules. Methods Ultrasonography and CDFI were performed on 69 patients with prostate nodules. Observe the shape, boundary and internal echo of the nodules. Record the blood characteristics of the nodules. Transrectal 13+ needles of prostate biopsy were performed. The relationship between ultrasonography & CDFI and the results of biopsy was studied. Results By transrectal biopsy of 69 cases of prostate nodules, diagnosis of 36 cases of cancer, 1 of lymphoma, 1 of atypical hyperplasia and 31 of benign prostatic hyperplasia had been obtained. The detection rate of prostate cancer was evaluated in the groups with different serum concentration of PSA. In the group with prostate specific antigen (PSA)<4.0 ng/mL, 4.1~10 ng/mL, 10.1~20 ng/mL, 20.1~30 ng/mL, 30.1~50 ng/mL, 50.1~100 ng/mL and>100 ng/mL, the positive rate of prostate cancer by biopsy was 21.42%, 33.33%, 44.44%,44.44%, 71.42%, 100.00% and 92.30% respectively. The difference of positive rates among the groups were statistically significant(P<0.05). Conclusion Transrectal 13+ needles biopsy of prostatic nodules is an effective method for diagnosis of prostatic cancer. In addition, digital rectal examination and serum content of PSA should be closely connected.
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