摘要目的　探讨B超引导下 前列腺穿刺筛查前列腺癌的临床意义。　方法　采用6针系统活检加 结节处2～4针活检，197例前列腺特异抗原(PSA)>4 ng/ml或有前列腺结节的患者行超声引 导下前列腺穿刺活检，对4例PSA持续升高者行重复穿刺。　结果　 有结节者107例中发现前列腺癌34例（31.8%），90例无结节者中发现前列腺癌11例（12.2% ）。分析显示：PSA越高，穿刺活检阳性率越高。重复穿刺者4例中发现前列腺癌1例。 　结论　对有前列腺结节或PSA>4 ng/ml的前列腺增生患者应行系统 活检以筛查前列腺癌，穿刺阴性后如 PSA持续增高则应重复穿刺。

abstractsObjective　To investigate the clinical signi fic ance of ultrasound-guided systematic biopsy in detecting prostate cancer in pat ients with PSA>4 ng/ml and/or with prostate nodule found on DRE or TRUS .　Methods　197 patients suspected of prostate carcinoma underwent ultrasound-guided sextant biopsy and 2～4 more cores in the nodule. Four patien ts whose initial biopsy was negative but subsequent PSA levels were continuousl y abnormal underwent repeated biopsies.　Results　Of the 1 07 cases with prostate nodules,in 34(31.8%) of them prostate cancer was detected ,while in 90 cases without a prostate nodule, only 11(12.2%) were positive. Stra t ified analysis on PSA found that the higher the PSA, the higher the positive bio psy rate of prostate carcinoma. In the 4 cases with repeated biopsies, 1 prosta te cancer was detected.　Conclusions　For patients with p rostate nodule and/or PSA over 4 ng/ml,systematic biopsy should be taken, with 2 or more cores toward the nodule.In the patients with continuous high PSA level s,if the first biopsy is negative, rebiopsy should be taken.