经直肠超声造影､血清前列腺特异性抗原检测在前列腺癌穿刺活检诊断中的应用  

Application of CE-TRUS and PSA in the diagnosis of prostate cancer by needle biopsy

作　　者：贺修宝 李灿[1] 胡小梅[1] HE Xiubao;LI Can;HU Xiaomei(Department of Ultrasound,Chenzhou First People′s Hospital,Chenzhou 423000,Hunan,China)

机构地区：[1]郴州市第一人民医院超声科,湖南郴州423000

出　　处：《中国性科学》2022年第2期9-12,共4页Chinese Journal of Human Sexuality

基　　金：郴州市第一人民医院院内课题(N2020-68)。

摘　　要：目的研究经直肠超声造影(CE-TRUS)､血清前列腺特异性抗原(PSA)在前列腺穿刺活检诊断前列腺癌(PCa)中的应用价值。方法选取2018年1月至2020年9月郴州市第一人民医院诊治的85例PCa患者作为研究组,另选取同期85例前列腺良性增生患者作为对照组。比较两组前列腺穿刺活检､CE-TRUS阳性率､血清PSA水平,分析前列腺穿刺活检､CE-TRUS､血清PSA单独及联合诊断PCa的价值,对比研究组不同Gleason分级患者CE-TRUS参数[达峰时间(TIP)､峰值强度(PI)､曲线下面积(AUC)]､血清PSA水平,分析CE-TRUS参数､血清PSA水平与Gleason分级的相关性及对Gleason分级的评估价值。结果研究组前列腺穿刺活检､CE-TRUS阳性率､血清PSA水平高于对照组(P<0.05);前列腺穿刺活检､CE-TRUS､血清PSA联合诊断PCa的AUC最大,为0.942;CE-TRUS的PI､AUC及血清PSA与Gleason分级呈正相关(P<0.05);CE-TRUS的PI､AUC及血清PSA联合评估PCa Gleason分级≥4+3的AUC优于上述指标单一评估。结论CE-TRUS联合血清PSA有助于提高前列腺穿刺活检诊断PCa的价值,可为临床评估PCa恶性程度､拟定个性化治疗方案提供循证支持。Objective To study the application value of contrast-enhanced transrectal ultrasound(CETRUS)and serum prostate specific antigen(PSA)in the diagnosis of prostate cancer(PCa)by needle biopsy.Methods 85 PCa patients treated in Chenzhou First People′s Hospital from January 2018 to September 2020 were selected as the study group,and 85 patients with benign prostatic hyperplasia in the same period were selected as the control group.Prostate biopsy,CE-TRUS positive rate and serum PSA level were compared between the two groups,and the value of prostate biopsy,CE-TRUS,serum PSA alone and in combination in diagnosis of PCa was analyzed.The parameters of CE-TRUS examination(TIP,PI,AUC),serum PSA level of patients were compared in patients with different Gleason grades.The correlation between CE-TRUS parameters,serum PSA levels and Gleason grade and its value in evaluating Gleason grade were analyzed.Results Prostate biopsy,CE-TRUS positive rate and serum PSA level in the study group were higher than those in the control group(P<0.05).The AUC of prostate biopsy combined with CE-TRUS and serum PSA in diagnosis of PCa was the highest(0.942).The PI,AUC of CE-TRUS and serum PSA were positively correlated with Gleason grading(P<0.05).The combination of PI,AUC of CE-TRUS and serum PSA in the assessment of PCa Gleason grade≥4+3 was better than the single evaluation of the above indicators.Conclusions CE-TRUS combined with serum PSA can improve the diagnostic value of prostate biopsy for PCa,and provide evidence-based support for clinical evaluation of PCa malignancy and personalized treatment.

关 键 词：前列腺特异性抗原 前列腺穿刺活检 前列腺癌 GLEASON分级 

分 类 号：R691[医药卫生—泌尿科学]