经直肠超声系统穿刺联合超微血管成像技术靶向穿刺在前列腺癌诊断中的应用  

Application of transrectal ultrasound system puncture combined with superb microvascular imaging technique targeted puncture in the diagnosis of prostate cancer

作　　者：何竹[1] 江泉[1] 张渊[1] 单君[1] 傅宇 周丽 陈珑[2] HE Zhu;JIANG Quan;ZHANG Yuan;SHAN Jun;FU Yu;ZHOU Li;CHEN Long(Department of Ultrasound,Shanghai Pudong New Area People's Hospital,Shanghai 201299,China;Department of Interventional Radiology,First Affiliated Hospital of Soochow University,Soochow,Jiangsu 215006,China)

机构地区：[1]上海市浦东新区人民医院超声科,上海201299 [2]苏州大学附属第一医院介入放射科,江苏苏州215006

出　　处：《中华肿瘤防治杂志》2024年第12期752-758,共7页Chinese Journal of Cancer Prevention and Treatment

基　　金：上海市浦东新区卫生健康委员会卫生计生科研项目(PW2021A-34)。

摘　　要：目的探讨经直肠超声(TRUS)系统穿刺联合超微血管成像(SMI)靶向穿刺在可疑前列腺癌诊断中的应用价值。方法回顾性选取2021-06-01-2023-02-28上海市浦东新区人民医院临床诊断为可疑前列腺癌,但在常规灰阶超声未发现可疑前列腺恶性病灶的患者共150例。按穿刺活检使用的超声引导技术分为3组:TRUS引导下系统穿刺活检联合超微血管成像(SMI)靶向穿刺活检组(TRUS+SMI组)52例,TRUS引导下系统穿刺活检联合超声造影(CEUS)靶向穿刺活检组(TRUS+CEUS组)54例,单独TRUS引导下系统穿刺活检组(TRUS组)44例。以手术病理结果或≥6个月临床随访结果为金标准,通过χ^(2)检验或Fisher精确概率法分析,评估3种方法引导下的经皮穿刺活检对前列腺癌的诊断效能。结果TRUS+SMI组中前列腺癌16例,而穿刺活检病理诊断15例为前列腺癌,漏诊1例,检出率为28.85%(15/52);TRUS+CEUS组中前列腺癌14例,而穿刺活检病理诊断13例为前列腺癌,漏诊1例,检出率为24.07%(13/54);单独TRUS组中前列腺癌13例,但穿刺活检病理仅诊断出7例为前列腺癌,漏诊6例,检出率为15.91%(7/44)。TRUS+SMI组、TRUS+CEUS组、单独TRUS组行穿刺活检的诊断准确度分别为98.08%(51/52)、98.15%(53/54)和86.36%(38/44),灵敏度分别为93.75%(15/16)、92.86%(13/14)和53.85%(7/13),差异均有统计学意义(P值分别为0.018和0.013),但组间两两比较差异无统计学意义,均P>0.017;3组穿刺活检的特异度均为100.00%。结论TRUS系统穿刺联合SMI靶向穿刺对前列腺癌的诊断灵敏度及准确度均高于单独TRUS引导下的系统穿刺,而与TRUS系统穿刺联合CEUS靶向穿刺对前列腺癌的诊断效能相近。TRUS系统穿刺联合SMI靶向穿刺能有效诊断前列腺癌。Objective To investigate the application value of transrectal ultrasound(TRUS)system puncture combined with superb microvascular imaging(SMI)targeted puncture in the diagnosis of suspected prostate cancer.Methods A total of 150 patients who were clinically diagnosed with suspected prostate cancer by Shanghai Pudong New Area People's Hospital from June 1,2021 to February 28,2023 were retrospectively selected,but no suspected malignant lesions of prostate were found by routine grayscale ultrasound.The patients were divided into three groups according to the different ultra-sound guidance techniques used for puncture biopsy:52 cases were in the TRUS-guided systematic puncture biopsy com-bined with SMI targeted puncture biopsy group(TRUS+SMI group),54 cases in the TRUS-guided systematic puncture biopsy combined with contrast-enhance ultrasound(CEUS)targeted puncture biopsy group(TRUS+CEUS group),and 44 cases in the TRUS-guided systematic puncture biopsy group(TRUS group)alone.Surgical pathologic results or clinical follow-up results of≥6 months were used as the gold standard,χ^(2) test or Fisher exact probability method were used to evaluate the diagnostic efficacy of three methods guided percutaneous puncture biopsy for prostate cancer.Results In the TRUS+SMI group,16 cases were diagnosed as prostate cancer,while 15 cases were pathologically diagnosed as prostate cancer by puncture biopsy,and 1 case was missed,the detection rate was 28.85%(15/52).In the TRUS+CEUS group,there were 14 cases of prostate cancer,while 13 cases were pathologically diagnosed as prostate cancer by puncture biopsy,and 1 case was missed,the detection rate was 24.07%(13/54).In the TRUS group alone,there were 13 cases of prostate cancer,but only 7 cases were pathologically diagnosed as prostate cancer by puncture biopsy,and 6 cases were missed,the detection rate was 15.91%(7/44).The diagnostic accuracy of puncture biopsy in TRUS+SMI group,TRUS+CEUS group and TRUS group alone was 98.08%(51/52),98.15%(53/54)and 86.36%(38/44),respectively,the d

关 键 词：前列腺癌 超微血管成像技术 超声造影 经直肠超声 靶向穿刺活检 

分 类 号：R737.25[医药卫生—肿瘤]