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目的:通过前列腺内各种回声结节的穿刺病理结果,探讨前列腺内异常回声结节的病理诊断与鉴别诊断对提高早期前列腺癌诊断率的意义。方法:对95例临床疑前列腺癌患者行经直肠超声(TRUS)引导下前列腺穿刺活检,除了行扩大范围系统活检外,并对前列腺内异常回声结节进行穿刺活检,分析其声像图特征与病理结果。结果:95例患者中,前列腺癌35例(36.8%),其中低回声结节16例(45.7%),强回声结节4例(11.4%),等回声结节10例(28.6%),混合性不均质回声5例(14.3%)。35例前列腺癌中,T2b期以内占46.2%(17/35),其中结节处检出前列腺癌阳性率70.6%(12/17),明显高于系统活检检出前列腺癌阳性率29.4%(5/17,P<0.05)。结论:对前列腺内异常回声结节的辨别与活检有利于前列腺疾病的诊断与鉴别诊断,并可提高早期前列腺癌诊断率,减少不必要的活检针数及减少患者不必要的痛苦,但它仍然不能代替传统的系统活检。
Objective: To explore the significance of pathological diagnosis and differential diagnosis of abnormal echogenic nodules in prostate to improve the diagnostic rate of early-stage prostate cancer through the pathological results of various echogenic nodules in the prostate. Methods: Ninety-five patients with suspected clinical prostate cancer underwent transrectal ultrasound (TRUS) guided prostate biopsy. In addition to expanding the scope of systematic biopsy, abnormal prostatic nodules in the prostate were punctured and biopsy was performed to analyze the features and pathology of sonography result. Results: Of the 95 patients, 35 (36.8%) had prostate cancer, 16 (45.7%) had hypoechoic nodules, 4 had hyperechoic nodules (11.4%), 10 had echogenic nodules (28.6%), Mixed heterogeneous echo in 5 cases (14.3%). In 35 cases of prostate cancer, the positive rate of prostate cancer was 70.6% (12/17) in T2b stage (46.2%, 17/35), which was significantly higher than the positive rate of prostate cancer detected by systematic biopsy (29.4%) 5/17, P <0.05). Conclusion: The identification and biopsy of abnormal echogenic nodules in prostate is helpful for the diagnosis and differential diagnosis of prostatic diseases. It can also improve the diagnostic rate of early-stage prostate cancer, reduce unnecessary needle biopsy and reduce unnecessary suffering of patients, but it still Can not replace the traditional system biopsy.