前列腺癌经直肠超声造影定量参数及分化程度与微血管密度相关性的初步研究  

Preliminary study on the relationship between contrast-enhanced transrectal ultrasound,histopathologic grading and microvessel density of prostate cancer

作　　者：吴成爱[1] 刘聪雅[1] 杨永生[1] 杨丽清[1] 陈武[1] 李廷廷[1] 赵育芳[1] 杜红枝 郝美芳[1] 

机构地区：[1]山西医科大学第一医院超声科,太原030001

出　　处：《中华超声影像学杂志》2015年第10期865-868,共4页Chinese Journal of Ultrasonography

基　　金：基金项目：山西省回国留学人员科研资助项目（2014-076）

摘　　要：目的探讨前列腺癌经直肠超声造影参数及分化程度与组织微血管密度（MVD）的相关性。方法109例血清前列腺特异性抗原（PSA）升高、临床疑诊恶性肿瘤患者，行经直肠前列腺超声造影及穿刺活检。使用时间-强度陆线分析软件分析造影图像，记录峰值强度（PI）、达峰时间（TTP）、到达时间（AT）、曲线下面积（AUC）、上升支斜率（α）、下降支斜率（β）、上升支斜率与下降支斜率的乘积（α×β）7个造影参数；记录每例患者的微血管密度（MVD）计数及癌症患者的Gleason评分，并依据腺体分化程度将其分为高分化组（〈4分）、中分化组（5～7分）、低分化组（8～10分）。比较各研究对象的造影参数及MVD计数，并分析其相关性。结果①穿刺活检病理结果证实44例前列腺癌，61例前列腺增生，3例局灶伴低级别前列腺上皮内瘤变，1例非特异性肉芽肿性前列腺炎。②造影参数分析结果：前列腺癌组PI、α、α×β大于增生组（P〈0．05），TTP、AT小于增生组，差异有统计学意义（P〈0．05）；AUC、0差异无统计学意义（P〉0．05）。③病理结果显示前列腺癌组MVD计数明显高于增生组，差异有统计学意义（P〈0．05）；不同分化程度组MVD计数两两比较，差异有统计学意义（P〈0．05）。④参数PI、α、α×β与MVD计数呈正相关（r=0．643，P=0．000；r=0．671，P=0．000；r=0．529，P=0．002）；AT、TTP与MVD计数呈负相关（r=-0．382，P=0．026；r=-0．720，P=0．000）。结论经直肠前列腺超声造影参数与MVD计数具有相关性；MVD计数随分化程度不同而不同。造影参数可推断前列腺病变微血管生成情况，有助于评价病变的良恶性及预后。Objective To explore the correlation between contrast-enhanced transrectal ultrasound （CETRUS） ,pathological levels and microvessel density（MVD） of prostate cancer. Methods A total of 109 patients with increased prostate specific antigen （PSA） level who suspected with prostate cancer（PCa）, CETRUS and prostate biopsy were taken one after another. To analyze images with time intensity curves analysis software, 7 parameters were measured. MVD was achieved through pathological findings. PCa patients were classified into well differentiated（less than 4 points）, moderately differentiated（between 5 to 7 points） and poor differentiated（between 8 to 10 points） according to the Gleason score and the different degree of the gland. The parameters and MVD of each group were contrasted, then the correlations between them were calculated. Results （1）The pathological results of prostate biopsy revealed 44 PCa patients,61 benign prostatic hyperplasia （BPH） patients, 3 prostatic intraepithelial neoplasia （PIN） patients and 1 prostate nonspecific granulomatous patient. （2）The value of each CETRUS parameter showed：PI,α, α×β in PCa group were higher than those in the BPH group（ P 〈0.05）. AT,TTP were lower in PCa group than those in the BPH group（ P 〈0.05）. There were no difference in AUC,β between two groups（ P〉0.05）. （3）Pathological findings showed： MVD in PCa group was higher than that in the BPH group, there was significant difference between two groups （ P 〈 0.05）. MVD at different levels in PCa group also weresignificant different（ P 〈0.05）. （4）There were positive correlations in PI, α, α×β and MVD between two groups（ r = 0.643, P = 0.000; r = 0.671, P = 0.000; r = 0.529, P = 0.002, respectively） , there were negative correlations in AT,TTP and MVD between two groups（ r = -0.382,P = 0.026; r = -0.720,P = 0.01）0,respectively）. Conclusions CETRUS parameters were correlated with MVD, MVD changed with pathological levels. So CETR

关 键 词：腔内超声检查 微气泡 前列腺肿瘤 微血管密度 

分 类 号：R445.1[医药卫生—影像医学与核医学] R737.25[医药卫生—诊断学]