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目的对照研究高频超声在前列腺穿刺的引导作用及发现微小病灶的作用,探讨P3、ki67、nm23等抗体在前列腺癌、高级别前列腺上皮内瘤变及良性前列腺增生组织中的表达及意义,判断肿瘤的预后。方法在直肠经彩色多普勒超声仪(高频)及穿刺导向器引导下,用美国BARD公司的18G组织切割针及配套第三代自动弹射式活检枪,经会阴穿刺,对前列腺左右叶各5点共10点标准穿刺,活检标本石蜡包埋,制作蜡块连续切片,进行HE染色,并做P3(即P504s/P63/HMW CK)联合ki67、nm23免疫组化检测,观察在前列腺穿刺活检中的作用。结果 P3结合ki67、nm23在前列腺癌、高级别前列腺上皮内瘤变及良性前列腺增生组织中的阳性表达差异有统计学意义。经会阴穿刺与经直肠穿刺相比较,减少感染的发生。结论经会阴前列腺10点标准穿刺法,结合临床和影像学资料,鸡尾酒抗体,可以得到较高的确诊率;高频超声可以发现微小病灶;ki67、nm23可用于前列腺良恶性疾病的诊断、鉴别诊断与预后判断。
Objective To study the role of high-frequency ultrasound in the prostatic puncture and the role of micro-lesions in detecting the expression and significance of P3, ki67, nm23 and other antibodies in prostate cancer, high-grade prostatic intraepithelial neoplasia and benign prostatic hyperplasia Prognosis of the tumor. Methods The rectum was guided by color Doppler ultrasonography (high frequency) and puncture guide, with 18G tissue cutting needle from American BARD company and the third generation automatic ejection biopsy gun. After perineal puncture, 5 points of a total of 10 points puncture biopsy specimens embedded in paraffin, making serial sections of wax, HE staining, and P3 (P504s / P63 / HMW CK) combined with ki67, nm23 immunohistochemistry to observe the prostate biopsy In the role. Results The positive expression of P3 in combination with ki67 and nm23 in prostate cancer, high-grade prostatic intraepithelial neoplasia and benign prostatic hyperplasia was statistically different. Transperineal puncture and rectal puncture compared to reduce the incidence of infection. Conclusions Ten points of perineal prostate puncture method combined with clinical and imaging data, cocktail antibodies, can get a higher diagnosis rate; high frequency ultrasound can be found in small lesions; ki67, nm23 can be used for benign and malignant prostate disease diagnosis, differential diagnosis And prognosis.