经直肠超声及血清学指标对前列腺癌Gleason分级的预测价值  

The predictive value of transrectal ultrasound and serological indicators in Gleason grading of prostate cancer

作　　者：王涛[1] 马丹丹 刘卫勇 Wang Tao;Ma Dandan;Liu Weiyong(Department of Ultrasound,the First Affiliated Hospital of University of Science and Technology of China,Hefei 230031,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)南区超声医学科,合肥230031

出　　处：《国际泌尿系统杂志》2023年第5期799-802,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨经直肠超声(TRUS)图像特征及前列腺特异性抗原(PSA)系列血清学指标对前列腺癌(PCa)患者的Gleason分级的预测价值。方法回顾性分析2020年12月至2021年11月在本院行经会阴前列腺穿刺活检术,并且经穿刺病理证实的52例PCa患者。依病理Gleason评分结果将患者分为中低危组(Gleason≤7,28例)及高危组(Gleason>7,24例)。对比分析两组的前列腺体积、前列腺内异常结节、经直肠实时弹性成像(TRTE)评分以及PSA系列血清学指标及其与Gleason分级的相关性。结果两组患者的年龄、前列腺总体积、移行区体积以及前列腺内异常结节最大径比较,差异均无统计学意义(均P>0.05),高危组的总前列腺特异性抗原(tPSA)、前列腺特异抗原密度(PSAD)、移行带前列腺特异性抗原密度(TPSAD)以及超声弹性评分高于中低危组,差异均有统计学意义(均P<0.05)。Spearman相关性分析结果显示,患者的PSAD、TPSAD、异常结节最大径以及超声弹性评分与Gleason分级呈正相关性(均P<0.05),而患者的年龄、前列腺体积、tPSA与Gleason分级无相关性(均P>0.05)。结论PSAD、TPSAD、异常结节最大径以及超声弹性评分与Gleason分级具有一定的相关性,可为临床精准化诊疗提供重要参考信息。Objective To investigate the prognostic value of transrectal prostate ultrasound image features and PSA indicators in Gleason grading of prostate cancer(Pca).Methods A retrospective analysis was performed on 52 patients with PCa who underwent perineal prostate biopsy in our hospital from December 2020 to November 2021 and were confirmed by biopsy pathology.According to pathological Gleason score,the patients were divided into two groups:medium-low risk(Gleason grade≤7,28 cases)and high risk(Gleason grade>7,24 cases).The statistical differences of prostate volume,abnormal nodules in prostate,transrectal real-time elastography(TRTE)score and related serological indicators between the two groups were analyzed and compared,and whether they were correlated with Gleason grade.Results There were no significant differences in age,total prostate volume,volume of the transitional zone and maximum diameter of lesions between the two groups(all P>0.05).Serological total prostatic specific antigen(tPSA),prostate-specific antigen density(PSAD),transzone prostate-specific antigen density(TPSAD)and ultrasound elasticity score of high-risk group were higher than those of middle-low risk group,with statistical significance(all P<0.05).Spearman correlation analysis showed that PSAD,TPSAD,maximum diameter of abnormal nodules and ultrasound elasticity score of the two groups were positively correlated with Gleason grade(all P<0.05),while age,prostate volume and tPSA of the patients were not correlated with Gleason grade(all P>0.05).Conclusions PSAD,TPSAD,maximum diameter of abnormal nodules and ultrasonic elastic score had certain correlation with Gleason grading,which will provide important information for clinical precision diagnosis and treatment.

关 键 词：前列腺肿瘤 超声检查 直肠镜检查 弹性成像技术 肿瘤分级 

分 类 号：R737.25[医药卫生—肿瘤]