声触诊弹性成像联合PSAD在前列腺良恶性疾病鉴别中的应用价值  

Application value of sound touch elastography combined with PSAD in differentiating benign and malignant prostatic diseases

作　　者：欧阳露 付海龙 朱雯 方文静 林秀梅 齐永涛 徐灵菲 王欣[1] 马桂凤[3] OUYANG Lu;FU Hailong;ZHU Wen;FANG Wenjing;LIN Xiumei;QI Yongtao;XU Lingfei;WANG Xin;MA Guifeng(School of Medical Imaging,Weifang Medical University,Weifang 261053,China;Department of Ultrasound,Maternal and Child Healty Care Hospital,Changyi Ciry,Weifang 261300,China;Department of Ultrasound,Affiliated Hospital of Weifang Medical University,Weifang 261042,China)

机构地区：[1]潍坊医学院医学影像学院,山东潍坊261053 [2]山东省昌邑市妇幼保健院超声科,山东潍坊261300 [3]潍坊医学院附属医院超声科,山东潍坊261042

出　　处：《医学影像学杂志》2023年第10期1858-1861,共4页Journal of Medical Imaging

摘　　要：目的探讨声触诊弹性成像技术(sound touch elastography,STE)联合前列腺特异性抗原密度(prostate specific antigen density,PSAD)在前列腺良恶性疾病鉴别中的应用价值。方法选取疑诊为前列腺癌(PCa)并拟行超声引导下穿刺活检的患者101例,穿刺前均行血清总前列腺特异性抗原(PSA)、经直肠双平面超声、STE检查并计算出PSAD。以穿刺活检的病理结果为金标准,将患者分为PCa组(n=48)和良性病变组(n=53),比较两组间PSA、PSAD、Emax及Emean差异。绘制受试者工作特征(ROC)曲线评估各指标诊断PCa的效能,Delong检验比较AUC之间的差异。结果与良性病变组相比,PCa组的PSA、Emean、Emax、PSAD均明显增高,差异均具有统计学意义(P<0.001)。PSA、PSAD、Emean及Emax诊断PCa的曲线下面积分别为0.770、0.810、0.755、0.748,灵敏度分别为85.4%、70.8%、62.5%、64.6%,特异度分别为54.7%、79.2%、81.1%、84.9%。Emean联合PSAD或Emax联合PSAD诊断PCa的曲线下面积分别为0.912、0.909,灵敏度分别为85.4%、91.7%,特异度分别为94.3%、84.9%。Delong检验显示STE联合PSAD后对PCa的诊断价值均高于任意单一指标,差异均有统计学意义(P<0.05)。结论STE联合PSAD在鉴别前列腺良恶性疾病方面的价值高于单纯STE或PSAD,有较高的灵敏度和特异度。Objective To investigate the value of sound touch elastography(STE)combined with prostate specific antigen density(PSAD)in differentiating benign and malignant prostate diseases.Methods 101 patients with suspected prostate cancer(PCa)who were scheduled for ultrasound-guided biopsy were collected.Serum total prostate specific antigen(PSA),transrectal biplane ultrasound,STE and PSAD were examined before puncture.Using the pathological results of needle biopsy as the gold standard,the patients were divided into PCa group(n=48)and benign disease group(n=53),and the differences in Emax,Emean,PSA and PSAD between the two groups were compared.Receiver operating characteristic(ROC)curves were plotted to assess the efficacy of each index in the diagnosis of PCa.Results Compared with the benign lesion group,PSA,Emean,Emax,and PSAD were significantly higher in the PCa group,and the differences were statistically significant(P<0.001).The area under the curve of PSA,PSAD,Emean and Emax in the diagnosis of PCa was 0.770,0.810,0.755 and 0.748,the sensitivity was 85.4%,70.8%,62.5%and 64.6%,and the specificity was 54.7%,79.2%,81.1%and 84.9%,respectively.The area under the curve of Emean combined with PSAD or Emax combined with PSAD in the diagnosis of PCa was 0.912 and 0.909,with sensitivities of 85.4%and 91.7%and specificities of 94.3%and 84.9%.Delong test showed that the diagnostic value of STE combined with PSAD for PCa was higher than any single index,and the differences were statistically significant(P<0.05).Conclusion STE combined with PSAD is more valuable than STE or PSAD alone in differentiating benign from malignant prostate diseases,with higher sensitivity and specificity.

关 键 词：前列腺癌 声触诊弹性成像 前列腺特异性抗原密度 超声检查 

分 类 号：R737.25[医药卫生—肿瘤] R445.1[医药卫生—临床医学]