3种无创检查在前列腺癌初筛诊断中的应用价值  

Three kinds of noninvasive screening application in diagnosis of early prostate cancer

作　　者：曹曙[1] 胡卫列[1] 韩立新[2] 曹惠霞[2] 

机构地区：[1]广州军区广州总医院泌尿外科,广州510000 [2]广州军区广州总医院磁共振室,广州510000

出　　处：《重庆医学》2014年第22期2868-2869,2872,共3页Chongqing medicine

摘　　要：目的：研究直肠指检（DRE）、经直肠超声检查（TRUS）及多参数磁共振成像（MP-MRI）在前列腺癌诊断的应用价值。方法回顾分析113例临床疑似前列腺癌患者数据。结果所有疑似前列腺癌患者中，DRE的灵敏度为33．3％，特异度为88．7％；TRUS的灵敏度为62．7％，特异度为67．7％；MP-MRI的灵敏度为86．3％，特异度为83．9％。3组间两两比较差异均具有统计学意义（P＜0．05）。在 PSA 4．0～10．0 ng/mL的 PSA灰区疑似前列腺癌患者中，DRE的灵敏度为27．8％，特异度为86．5％；TRUS的灵敏度为44．4％，特异度为59．5％；MP-MRI的灵敏度为77．8％，特异度为81．1％。3组间两两比较差异均具有统计学意义（P＜0．05）。结论 MP-MRI在前列腺癌诊断中表现出了较好的检测效能，并能减少灰区前列腺癌的漏诊，具有重要价值。Objective To evaluate the effect of noninvasive diagnosis methods direct rectal examination （DRE） ,transrectal ultra-sonography（TRUS） and multiparametric magnetic resonance imaging（MP-MRI） for prostate cancer detection .Methods The clini-cal data of 113 patients suspected prostatic cancer were analyzed retrospectively .Every patient was examined by TRUS ,DRE and MP-MRI before pathology or operation .The sensitivity rate and the specificity rate of DRE ,TRUS and MP-MRI were calculated and compared among the three methods .Results The sensitivity rate and the specificity rate of prostate cancer were 33 .3% and 88 .7% for DRE ,62 .7% and 67 .7% for TRUS ,86 .3% and 83 .9% for MP-MRI respectively ,two comparison between the three group had statisfically difference（P〈0 .05） .But ,of prostate cancer with prostate specific antigen （PSA） 4 .0~10 .0 ng/mL in gray zone ,the sensitivity rate and the specificity rate were 27 .8% and 86 .5% for DRE ,44 .4% and 59 .5% for TRUS ,77 .8% and 81 .1% for MP-MRI ,two comparison between the three group had statisfically difference（P〈0 .05） .Conclusion MP-MRI has bet-ter detection efficiency .It could obviously reduce the missed diagnosis rate on PCA with PSA in gray zone .

关 键 词：前列腺癌 磁共振成像 经直肠超声检查 直肠指检 

分 类 号：R737.25[医药卫生—肿瘤]