Abstract:Objective To investigate the detection rate and safety of transrectal and transperineal puncture biopsy for prostate cancer. Methods Retrospective analysis was performed on 80 patients undergoing transrectal prostate puncture biopsy (transrectal group) and 80 patients undergoing transperineal prostate puncture biopsy (transperineal group) admitted to the Department of Urology, Liyang Branch of Jiangsu Provincial People’s Hospital from May 2015 to January 2020 were selected. The general data, the detection rate of prostate cancer, the occurrence of complications, and the perioperative conditions of prostate cancer patients undergoing radical resection were compared between two groups. Results There were no significant differences in age, body mass index, longest nodules meridian, number of nodules, prostate volume, total prostate specific antigen, Gleason score, number of puncture needles, number of positive puncture needles and number of unqualified samples between two groups (P > 0.05). The puncture time in transperineal group was longer than that in transrectal group (P < 0.01). There was no significant difference in the detection rate of prostate cancer between two groups (P > 0.05). The incidence of total complications in transperineal group was lower than that in transrectal group (P < 0.01). The interval of puncture to radical operation, radical operation time in transperineal group were shorter than those in transrectal group, and intraoperative blood loss, intraoperative prostate tissue adhesion rate were lower than those in transrectal group (P < 0.05 or P < 0.01). Conclusion Compared with transrectal prostate cancer puncture biopsy, transperineal puncture biopsy has higher safety and less negative impact on radical surgery.
蒋科 杭震宇 马鸿翔 吴 鸣. 经直肠与经会阴前列腺癌穿刺活检的检出率及安全性比较[J]. 中国医药导报, 2021, 18(14): 103-106.
JIANG Ke HANG Zhenyu MA Hongxiang WU Ming. Comparison of the detection rate and safety of transrectal and transperineal puncture biopsy for prostate cancer. 中国医药导报, 2021, 18(14): 103-106.
[1] Rebecca LS,Kimberly DM,Ahmedin J. Cancer Statistics,2018 [J]. CA Cancer J Clin,2018,68(1):7-30.
[2] 付振涛,郭晓雷,张思维,等.2015年中国前列腺癌发病与死亡分析[J].中华肿瘤杂志,2020,42(9):718-722.
[3] 樊博,齐盼,苏建志,等.河北医科大学第四医院前列腺癌患者的基线特征与生存分析[J].中国癌症杂志,2020, 30(8):620-625.
[4] 孙健,赵学媛,于阳.前列腺癌早期影像学诊断进展[J].癌症进展,2020,18(6):560-562,587.
[5] 姬宏利,王梅,苗朋.晚期前列腺癌的治疗进展[J].检验医学与临床,2020,17(20):3041-3044.
[6] 王栋,李沛衡,纪志刚,等.我国前列腺癌的健康筛查和早期诊疗方面的回顾和总结[J].国际外科学杂志,2020, 47(9):577-581.
[7] 陈妹,陈玲,曹明杰.游离前列腺特异性抗原联合癌胚抗原对前列腺癌的早期诊断价值[J].中国现代医学杂志,2020,30(20):82-86.
[8] 钟宇,田芳,邹明宇,等.基于PI-RADS v2.1不同参数磁共振成像对前列腺癌诊断效能的比较[J].中国医科大学学报,2020,49(10):915-920.
[9] 胡起立,宋黎涛,黄松.3.0T动态增强MRI联合fPSA/tPSA检测对前列腺癌的诊断效能[J].影像科学与光化学,2020,38(5):871-875.
[10] 杨关印,王瑞雨,赵帅林,等.经直肠超声弹性成像在前列腺癌诊断中的应用价值[J].中国实验诊断学,2020, 24(9):1409-1413.
[11] 胡梦博,杨天,吴亦硕,等.前列腺穿刺结果的多参数预测列线图模型建立:上海单中心1585例经会阴前列腺穿刺回顾[J].复旦学报:医学版,2020,47(1):12-18.
[12] Willie H,Samuel WD. Merriel,Garth Funston.Prostate Cancer in Primary Care [J]. Adv Ther,2018,35(9):1285-1294.
[13] 郝一昌,颜野,张帆,等.穿刺活检单针阳性的前列腺癌手术策略选择及经验总结[J].北京大学学报:医学版,2020,52(4):625-631.
[14] 成戈,杨新官,苏文,等.标准化表观扩散系数值对不同Gleason评分前列腺癌诊断价值[J].实用放射学杂志,2020,36(6):926-930,948.
[15] 王磊,蒋淑婉,杨家佳,等.直肠超声引导经会阴途径穿刺活检诊断前列腺癌[J].现代肿瘤医学,2017,25(18):2944-2950.
[16] 赵承琳,张艺,杨正汉.多参数MRI应用PI-RADSv2对前列腺临床显著癌的诊断效能评估[J].临床和实验医学杂志,2020,19(13):1365-1368.
[17] 钟明浩,候文忠,张志.3.0T磁共振弥散加权成像、表观弥散系数、波谱成像联合血清前列腺特异性抗原在前列腺癌诊断中的效能分析[J].中国医药科学,2019,9(5):117-119.
[18] 熊志勇.碘伏彻底消毒法预防经直肠超声引导下前列腺穿刺术术后感染的临床效果[J].中国当代医药,2019, 26(9):44-46.
[19] Lee CU,Sung SH,Jang CT,et al. Cancer Location in Upgrading and Detection after Transperineal Template-Guided Mapping Biopsy for Patients in Active Surveillance and Negative Transrectal Ultrasonography-Guided Prostate Biopsy [J]. Urol Int,2019,103(3):262-269.
[20] 王琦,蔡杰,欧彤文,等.MRI-TRUS融合引导经会阴前列腺靶向结合饱和穿刺活检的临床应用[J].中华医学超声杂志:电子版,2019,16(6):458-464.
[21] 邓君鹏,李权,刘超,等.经会阴模板引导与经直肠前列腺穿刺活检比较[J].国际泌尿系统杂志,2019,39(6):993-996.
[22] Borghesi M,Ahmed H,Nam R,et al. Complications After Systematic,Random,and Image-guided Prostate Biopsy [J]. Eur Urol,2017,71(3):353-365.
[23] Xue J,Qin Z,Cai H,et al. Comparison between transrectal and transperineal prostate biopsy for detection of prostate cancer:a meta-analysis and trial sequential analysis [J]. Oncotarget,2017,8(14):23322-23336.
[24] Xiang J,Yan H,Li J,et al. Transperineal versus transrectal prostate biopsy in the diagnosis of prostate cancer:a systematic review and meta-analysis [J]. World J Surg Oncol,2019,17(1):31.
[25] 洪睿霞,李芳.经直肠与经会阴途径穿刺活检诊断前列腺癌的对比分析[J].中国介入影像与治疗学,2019,16(9):555-559.
[26] Pal RP,Ahmad R,Trecartan S,et al. A Single Center Evaluation of the Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging against Transperineal Prostate Mapping Biopsy:An Analysis of Men with Benign Histology and Insignificant Cancer following Transrectal Ultrasound Biopsy [J]. J Urol,2018,200(2):302-308.
[27] Stefanova V,Buckley R,Flax S,et al. Transperineal Prostate Biopsies Using Local Anesthesia:Experience with 1,287 Patients. Prostate Cancer Detection Rate,Complications and Patient Tolerability [J]. J Urol,2019,201(6):1121-1126.
[28] 张新,杨永姣,刘莉,等.经直肠和经会阴径路前列腺穿刺活检术对行腹腔镜下根治性前列腺切除术围术期影响[J].天津医科大学学报,2018,24(4):312-314,322.