经直肠超声造影对高级别前列腺癌新辅助内分泌治疗疗效的评价及对指导预后干预的价值探究  

Evaluation of the efficacy of transrectal ultrasonography in neoadjuvant endocrine therapy for high-grade prostate cancer and its value in guiding prognostic interventions

作　　者：肖庆[1] 徐金顺 饶宏波 罗鑫 唐亮 Xiao Qing;Xu Jinshun;Rao Hongbo;Luo Xin;Tang Liang(The Third Hospital of Mianyang,Sichuan,Mianyang 621000,China;Department of Ultrasound Medicine,Sichuan Cancer Hospital,Chengdu 610000,China)

机构地区：[1]四川省绵阳市第三人民医院,绵阳621000 [2]四川省肿瘤医院超声医学科,成都610000

出　　处：《广西医科大学学报》2023年第11期1896-1901,共6页Journal of Guangxi Medical University

基　　金：2020年四川省医学(青年创新)科研课题资助项目(No.S20021)。

摘　　要：目的:探究经直肠超声造影(CETRUS)评估高级别前列腺癌(HGPCa)新辅助内分泌治疗(NHT)疗效及指导预后干预的价值。方法:选取2019年3月至2021年3月四川省绵阳市第三人民医院98例HGPCa患者,均行NHT,并统计NHT疗效;根据NHT疗效分为疗效良好组和疗效不良组,比较两组临床资料、CETRUS参数〔峰值强度(PI)、平均通道时间(MTT)、曲线下面积(AUC)、强度减半时间(HT)、上升支斜率(WIS)〕及血清前列腺特异性抗原(PSA)水平,分析HGPCa患者CETRUS参数与血清PSA水平的相关性,通过受试者工作特征(ROC)曲线分析CETRUS参数、血清PSA水平评估HGPCa患者NHT疗效的价值。所有患者NHT后均行腹腔镜前列腺癌根治术,术后随访1年,统计随访情况。结果:HGPCa患者NHT的疗效良好率为52.04%(51/98);疗效不良组NHT后PI、MTT、AUC、HT、WIS及血清PSA水平均高于疗效良好组(P<0.05);HGPCa患者NHT后PI、MTT、AUC、HT、WIS与血清PSA水平呈正相关关系(P<0.05);NHT后PI、MTT、AUC、HT、WIS评估疗效不良的AUC分别为0.760、0.793、0.778、0.830、0.814,且均与血清PSA评估疗效不良的AUC接近;CETRUS对HGPCa患者生化复发检出率为86.96%(20/23)。结论:CETRUS参数在评估HGPCa患者NHT疗效方面具有一定效能,且能检出生化复发,有助于指导临床开展预后干预。Objective:To investigate the value of transrectal ultrasonography(CETRUS)to assess the efficacy of neoadjuvant endocrine therapy(NHT)for high-grade prostate cancer(HGPCa)and to guide prognostic interventions.Methods:Ninety-eight patients with HGPCa in the Third Hospital of Mianyang of Sichuan from March 2019 to March 2021,all of whom underwent NHT,were selected and the efficacy of NHT was counted.According to the efficacy of NHT,the patients were divided into good efficacy group and poor efficacy group,and the clinical data,CETRUS parameters[peak intensity(PI),mean passage time(MTT),area under the curve(AUC),intensity halving time(HT),wedge inclination slope(WIS)]and serum prostate-specific antigen(PSA)level were compared between the two groups.The correlation between CETRUS parameters and serum PSA level in HGPCa patients was analyzed,and the value of CETRUS parameters and serum PSA level in assessing the efficacy of NHT in HGPCa patients was analyzed by the receiver operating characteristic(ROC)curve.All patients underwent laparoscopic radical prostatectomy after NHT and were followed up for 1 year after surgery,and the followup was counted.Results:The rate of good efficacy of NHT in HGPCa patients was 52.04%(51/98);PI,MTT,AUC,HT,WIS and serum PSA level after NHT in the poor efficacy group were higher than those in the good efficacy group(P<0.05);PI,MTT,AUC,HT and WIS were positively correlated with serum PSA level in HGPCa patients after NHT(P<0.05);the AUCs of PI,MTT,AUC,HT,and WIS after NHT to assess poor efficacy were 0.760,0.793,0.778,0.830,and 0.814,respectively,and all of them were close to the AUC of serum PSA to assess poor efficacy;the biochemical recurrence detection rate of CETRUS in HGPCa patients was 86.96%(20/23).Conclusion:CETRUS parameters are efficacious in assessing the efficacy of NHT in patients with HGPCa and can detect biochemical recurrence,which can help guide clinical interventions for prognosis.

关 键 词：高级别前列腺癌 经直肠超声造影 新辅助内分泌治疗 疗效 预后 

分 类 号：R445.1[医药卫生—影像医学与核医学]