Abstract：Objective: To explore the clinical value and safety of TRUS-guided transperineal biopsy with the 12+X method in the diagnosis of prostate carcinoma. Methods: A total of 1300 men underwent TRUS-guided transperineal biopsy with the 12+X method for suspected prostate carcinoma from Sep. 2009 to May 2014. The average age was 70.5 years old. All patients received PSA level, digital rectal examination(DRE), TRUS and MRI examinations. 937 cases received 12+X-core method biopsy and 363 cases received 12-core biopsy. Their clinical data were retrospectively analyzed. Results: The average number of biopsy core was 14.5(range 12 to 24). The average operation time was 20.4 min(15 to 30 min). Prostate carcinoma was detected in 540(41.5%), accounting for 13.1%, 17.1%, 31.9% and 73.8% in those with PSA ＜4.0 μg/L, 4-＜10 μg/L, 10-20 μg/L and >20 μg/L respectively, 24.0% in those with abnormal findings DRE, 30.1% in those with abnormal echoes on TRUS and 59.2% in those with abnormal echoes on MRI. Complications after prostatic biopsy included gross hematuria in 201 cases, acute urinary retention in 21 and fever in 5, but no other serious complications were observed. The positive rate was 47.2% in 12+X-core group and 34.5% in 12-core group. Conclusions: TRUS-gu ided transpefineal biopsy with the 12+X method, with high accuracy and fewer complications, is an ideal approach to the diagnosis of prostate carcinoma.
[1]那彦群,叶章群,孙光.中国泌尿外科疾病诊断治疗指南.北京:人民卫生出版社,2013. [2]孙颖浩.我国前列腺癌的研究现状.中华泌尿外科杂志,2004,25(2):77-80 [3]Hodge KK, McNeal JE, Terris MK, et al. Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate. J Urol, 1989, 142(1):71-75. [4]唐杰.发展中的超声引导前列腺多点穿刺活检.中华医学超声杂志(电子版),2005,2(3):129-130. [5]Durkan GC, Sheikh N, Johnson P, et al. Improving prostate cancer detection with an extended-core transrectal ultrasonography-guided prostate biopsy protocol. BJU Int, 2002, 89(1):33-39. [6]Rochester MA, Grifin S, Chappell B, et al. A prospective randomisedtrial ofextended core prostate biopsy protocols utilizing 12 versus 15 cores. Urol Int, 2009, 83(2):155-159. [7]Uno H, Nakano M, Ehara H, et al. Indications for extended 14 coretransrectal ultrasound-guided prostate biopsy. Urology, 2008, 71(1):23-27. [8]Abd TT, Goodman M, Hall J, et al. Comparison of 1 2-core versus 8-core prostate biopsy:multivariate analysis of large series of US veterans. Urology, 2011, 77(3):541-547. [9]Yoon BI, Shin TS, Cho HJ, et al. Isit efectiveto perform twomore prostate biopsies according to prostate-specific antigen level and prostate volume in detecting prostate cancer? Prospective study of 10-core and 12-core prostate biopsy. Urol J, 2012, 9(2):491-497. [10]Chen ME, Johonston DA, Tang K, et al. Detailed mapping of prostate carcinoma foci:Biopsy strategy implications. Cancer, 2000, 89(8):1800-1809. [11]Vis AN, Boerma MO, Ciatto S, et al. Detection of prostate cancer:a comparative study of the diagnostic efficacy of sextant transrectal versus sextant transperineal biopsy. Urology, 2000, 56(4):617-621. [12]Caroline MM, Nicola LR, Nasr A, et al. Image-guided prostate biopsy using magnetic resonance imaging-derived targets:a systematic review. Eur Urol, 2013,63(1):125-140. [13]Fiard G, Hohn N, Descotes JL, et al. Targeted MRI-guided prostate biopsies for the detection of prostate cancer:initial clinical experience with real-time 3-dimensional transrectal ultrasound guidance and magnetic resonance/transrectal ultrasound image fusion. Urology, 2013,81(6):1372-1378. [14]付帅,唐宇哲,张明博,等.超声弹性成像技术在诊断前列腺疾病中的应用进展.中华医学超声杂志(电子版), 2014,11(3):5-7. [15]Simmons LA, Ahmed HU, Moore CM, et al. The PICTURE study--prostate imaging (multi-parametric MRI and Prostate HistoScanningTM) compared to transperineal ultrasound guided biopsy for significant prostate cancer risk evaluation. Contemp Clin Trials, 2014,37 (1):69-83.
