磁共振-经直肠超声认知融合引导下前列腺靶向穿刺联合系统穿刺对血清前列腺特异性抗原水平4~20 ng/mL患者的前列腺癌诊断有效性  

Effectiveness of magnetic resonance imaging-transrectal ultrasound-guided cognitive fusion targeted prostate biopsy combined with systematic prostate biopsy for prostate cancer patients with PSA Level 4-20 ng/mL

作　　者：陆健斐[1] 冯蕾[1] 卜锐[1] 韦海荣[2] 刘小艳[1] 章然[3] LU Jianfei;FENG Lei;BU Rui;WEI Hairong;LIU Xiaoyan;ZHANG Ran(Department of Ultrasound,Second Affiliated Hospital of Kunming Medical university,Kunming 650000,China;Department of Urological Surgical,Second Affiliated Hospital of Kunming Medical university,Kunming 650000,China;Department of Cardiology,Second Affiliated Hospital of Kunming Medical university,Kunming 650000,China)

机构地区：[1]昆明医科大学第二附属医院超声医学科,云南昆明650000 [2]昆明医科大学第二附属医院泌尿外科,云南昆明650000 [3]昆明医科大学第二附属医院心内科,云南昆明650000

出　　处：《分子影像学杂志》2021年第6期932-936,共5页Journal of Molecular Imaging

基　　金：云南省基础研究计划(昆医联合专项)[2019FE001(-068)];院内科技计划项目(2018yk019)。

摘　　要：目的评价磁共振—经直肠超声认知融合引导下前列腺靶向穿刺(CFTB)联合经直肠超声引导下系统穿刺(SB)与单纯经直肠超声引导下SB对前列腺特异性抗原(PSA)在4~20 ng/mL水平患者的前列腺癌诊断的有效价值。方法选取我院接收的血清PSA水平4~20 ng/mL且首次经历经直肠超声引导下前列腺穿刺活检的337例患者,按穿刺活检前是否行MRI检查,将患者分为CFTB+SB组(n=177)和单纯行SB组(n=160)。比较两组患者穿刺阳性率、单针阳性率、临床显著性前列腺癌(CSPCa)及临床非显著性前列腺癌的检出率。结果CFTB+SB组患者穿刺阳性率、单针阳性率和CSPCa检出率均高于单纯行SB的患者(40.1%vs 26.3%;17.5%vs 10.3%;38.4%vs 20.6%,P<0.05),而临床非显著性前列腺癌检出率低于SB组患者(1.7%vs 5.6%,P<0.05);对CFTB+SB组内CFTB+SB与仅行CFTB的CSPCa检出率一致性比较显示:CFTB+SB与仅行CFTB对CSPCa检出有较高的一致性(Kappa=0.860),CFTB+SB的CSPCa检出率高于仅行CFTB(40.1%vs 36.1%,P<0.05)。结论磁共振—经直肠超声认知融合引导下前列腺靶向穿刺联合系统穿刺法对血清PSA在4~20 ng/mL水平的临床可疑前列腺癌患者有较高的临床诊断价值。Objective To evaluate the diagnostic value of MRI/transrectal ultrasound(TRUS)cognitive fusion targeted prostate biopsy(CFTB)combined with Transrectal Ultrasound-guided systematic prostate biopsy(SB)for patients with prostate specific antigen level 4-20 ng/mL.Methods A total of 337 patients with serum PSA level 4-20 ng/mL who underwent TRUS guided prostate biopsy for the first time in our hospital were included.They were randomly divided into CFTB+SB group(n=177)and SB group(n=160)according to whether MRI examination was performed before the biopsy.The positive rate of puncture,positive rate of single needle,detection rate of clinically significant prostate cancer(CSPCa)and clinically insignificant prostate cancer were compared between two groups.Results The positive rate of puncture,positive rate of single needle and detection rate of CSPCa in CFTB+SB group were significantly higher than those in SB(40.1%vs 26.3%,17.5%vs 10.3%,38.4%vs 20.6%,P<0.05).While the detection rate of clinically insignificant prostate cancer in CFTB+SB group was significantly lower than those in SB(1.7%vs 5.6%,P<0.05).The consistency comparison of CSPCa detection rates in CFTB+SB group showed that CSPCa detection rates had high consistency betwen CFTB+SB and CFTB only(Kappa=0.860).The CSPCa detection rate of of CFTB+SB was higher than that of CFTB(40.1%vs 36.1%,P<0.05).Conclusion TB guided by MRI/TRUS cognitive fusion combined with SB have high clinical diagnostic value for patients with serum prostate specific antigen level 4-20 ng/mL,who were suspected prostate cancer prostate.

关 键 词：认知融合靶向穿刺 前列腺系统穿刺 前列腺特异性抗原 前列腺癌 

分 类 号：R737.25[医药卫生—肿瘤]