经直肠超声造影评估前列腺癌新辅助内分泌治疗反应的价值  

Value of contrast-enhanced transrectal ultrasound in evaluating the response of prostate cancer to neoadjuvant hormonal therapy

作　　者：赵云歆[1] 张贝 王晓莲 周诗卉 蔡秋琼[1] 康慧莉[1] 孙剑 姚广力[1] ZHAO Yunxin;ZHANG Bei;WANG Xiaolian;ZHOU Shihui;CAI Qiuqiong;KANG Huili;SUN Jian;YAO Guangli(Department of Ultrasound,Shanghai Punan Hospital of Pudong New District,Shanghai 200125,China)

机构地区：[1]上海市浦东新区浦南医院超声科,上海200125

出　　处：《肿瘤影像学》2024年第3期315-322,共8页Oncoradiology

基　　金：上海市卫生健康委员会科研项目(202150009)。

摘　　要：目的:探讨经直肠超声造影(contrast-enhanced transrectal ultrasound)时间-强度曲线(time-intensity curve,TIC)参数评估前列腺癌(prostate cancer,PCa)患者对新辅助内分泌治疗(neoadjuvant hormonal therapy,NHT)的反应程度。方法:纳入27例接受NHT的PCa患者的临床资料,根据术后病理学检查结果分为有效组(n=16)和无效组(n=11)。对比两组患者临床病理学特征、治疗前后血清前列腺特异性抗原(prostate-specific antigen,PSA)和CETRUS检查指标及其变化率,以筛选与NHT反应性有关的潜在指标。进一步采用相关性分析评价其在评估患者对NHT反应方面的价值。结果:有效组和无效组在临床病理学特征、治疗前的血清PSA和C E T R U S检查指标方面的差异无统计学意义(均P>0.05)。治疗后,仅有效组的TIC曲线下面积(area under curve,AUC)低于无效组(560 dB·s vs 710 dB·s),其变化率大于无效组(-27.1%vs-5.3%)(均P<0.05)。相关性分析显示AUC变化率与组织学反应评分之间的相关性略高于治疗后AUC(r为-0.690 vs-0.630)。结论:CETRUS TIC参数中,NHT后的AUC及其变化率在评估PCa患者对NHT反应方面具有较好的价值。其中,AUC变化率可能与治疗反应程度更相关。Objective:To investigate the value of contrast-enhanced transrectal ultrasound(CETRUS)time-intensity curve(TIC)parameters in assessing the response of prostate cancer(PCa)patients to neoadjuvant hormonal therapy(NHT).Methods:The clinical data of 27 PCa patients who received NHT were included.Based on postoperative pathology,patients were divided into the effective(n=16)and ineffective(n=11)groups.Clinical pathological characteristics,serum prostate-specific antigen(PSA)levels,and CETRUS examination parameters and their change rates before and after treatment were compared between the two groups to identify potential indicators related to NHT response.Further,correlation analysis was used to evaluate their value in assessing patient response to NHT.Results:No significant differences were observed between the effective and ineffective groups in clinical pathological characteristics,pre-treatment serum PSA levels,and CETRUS parameters(all P>0.05).After treatment,the area under the TIC(AUC)was lower in the effective group compared to the ineffective group(560 dB·s vs 710 dB·s),with a greater change rate(-27.1%vs-5.3%)(both P<0.05).Correlation analysis showed that the AUC change rate had a slightly higher correlation with histological response scores than the post-treatment AUC(r:-0.690 vs-0.630).Conclusion:In CETRUS TIC parameters,the posttreatment AUC and its change rate have a good predictive value for assessing the response of PCa patients to NHT,with the AUC change rate potentially more related to the degree of treatment response.It helps in developing more targeted treatment strategies and improving the treatment outcomes for PCa patients.

关 键 词：前列腺癌 新辅助内分泌治疗 经直肠超声造影 时间-强度曲线 前列腺特异性抗原 治疗反应 

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