摘要
目的探讨12针前列腺穿刺活检在前列腺癌临床诊断中的应用价值,结合单针阳性结果,分析其临床病理意义。方法选取2018年4月至2020年3月于龙岩市第二医院接受12针前列腺穿刺活检、腹腔镜下前列腺癌根治术的52例前列腺癌患者作为研究对象,对比分析术前穿刺活检和术后病理检查结果,判断肿瘤临床分期和病理分级结果的一致性。结果12针前列腺穿刺活检后,穿刺病理Gleason评分为(6.29±0.48)分,术前临床分期T_(1c)、T_(2a)、T_(2c)分别为23例、21例和7例,而术后病理Gleason评分为(6.63±0.44)分,术后病理分期T_(2a)、T_(2b)、T_(2c)、T_(3)分别为14例、2例、33例以及3例,外周神经侵犯阳性、切缘阳性分别为23例和17例。与术后病理检查结果相比,术前穿刺活检的Gleason评分存在低估18例,一致30例,高估4例。通过多因素logistic回归分析,肿瘤穿刺百分比是导致术前低估Gleason评分的主要危险因素,同时也是导致外周神经侵犯阳性的影响因素。结论在12针前列腺穿刺活检中,单针阳性可作为判断前列腺癌发生的依据,但往往会低估肿瘤负荷,无法准确判断癌灶分布及病理分级,还应针对单针阳性患者的临床和病理特征进行深入探讨,对于病情做出准确的判断。
Objective To investigate the clinical value of 12 needle prostate biopsy in the diagnosis of prostate cancer,and to analyze its clinicopathological significance combined with single needle positive results.Methods A total of 52 patients with prostate cancer who received 12 needle prostate biopsy and laparoscopic radical prostatectomy in our hospital from April 2018 to March 2020 were selected as the research objects,and the results of preoperative biopsy and postoperative pathological examination were compared and analyzed to judge the consistency of tumor clinical stage and pathological grading.Results After 12 needle prostate biopsy,the Gleason score was(6.29±0.48)scores,the preoperative clinical stages of T_(1c),T_(2a) and T_(2c) were 23 cases,21 cases and 7 cases respectively,while the postoperative pathological Gleason score was(6.63±0.48),the postoperative pathological stage of T_(2a),T_(2b),T_(2c) and T_(3) were 14 cases,2 cases,33 cases and 3 cases respectively.The positive rate of peripheral nerve invasion and cutting edge were 23 cases and 17 cases respectively.Compared with the results of postoperative pathological examination,the Gleason score of preoperative biopsy was underestimated in 18 cases,consistent in 30 cases and overestimated in 4 cases.Multivariate logistic regression analysis showed that the percentage of tumor puncture was the main risk factor for preoperative underestimation of Gleason score,and it was also the influencing factor for positive peripheral nerve invasion.Conclusion In the 12 needle prostate biopsy,single needle positive can be used as the basis for judging the occurrence of prostate cancer,but it often underestimates the tumor load and can not accurately judge the distribution and pathological grading of cancer focus.We should also conduct indepth discussion on the clinical and pathological characteristics of patients with single needle positive,so as to make an accurate judgment of the disease condition.
作者
陶群星
TAO Qunxing(Department of Pathology,Longyan Second Hospital,Longyan 364000,China)
出处
《中国医药指南》
2021年第33期76-77,共2页
Guide of China Medicine
关键词
前列腺癌
12针前列腺穿刺活检
单针阳性
临床病理
Prostate cancer
12 needle prostate biopsy
Single needle positive
Clinical pathology
