两种经直肠超声引导下穿刺方法对可疑前列腺癌的诊断效能比较  

Comparison of the diagnostic efficacy of two transrectal ultrasound-guided puncture methods for suspected prostate cancer

作　　者：张玉 汪颖 Yu Zhang;Ying Wang(Department of Ultrasound,Shanghai Fengxian District Central Hospital,Shanghai 201400,China)

机构地区：[1]上海市奉贤区中心医院超声科,上海市201400

出　　处：《中国肿瘤临床》2025年第4期183-187,共5页Chinese Journal of Clinical Oncology

摘　　要：目的:探究经直肠常规超声引导下系统穿刺和经直肠超声造影成像(contrast-enhanced ultrasonography,CEUS)引导下靶向穿刺诊断可疑前列腺癌(prostate cancer,PCa)的诊断效能。方法:选择2021年2月至2024年2月在上海市奉贤区中心医院疑诊为PCa的239例患者,有139例接受直肠CEUS引导下经直肠穿刺活检,采用靶向穿刺法,纳入造影组,有100例接受常规超声引导下直肠穿刺活检,采用12点穿刺法,纳入常规组。比较两组PCa检出率、有临床意义前列腺癌(clinically significant prostate cancer,CsPCa)检出率,并分析不同亚组间的PCa检出率;比较两组穿刺针数、单针阳性针数和穿刺相关并发症。结果:经手术病理结果证实,造影组经穿刺确诊PCa 75例(53.96%),良性病变64例(46.04%);常规组经穿刺确诊PCa 38例(38.00%),良性病变62例(62.00%)。造影组PCa检出率显著高于常规组(P<0.05)。造影组不同年龄、前列腺特异抗原(prostate specific antigen,PSA)水平之间的PCa检出率差异均有统计学意义(P<0.05),常规组不同PSA水平之间的PCa检出率差异有统计学意义(P<0.05),当年龄>70岁时,造影组PCa检出率显著高于常规组(P<0.05),当PSA水平>20 ng/mL时,造影组PCa检出率显著高于常规组(P<0.05),当前列腺体积在31~60 cm^(3)之间时,造影组PCa检出率显著高于常规组(P<0.05)。造影组靶向穿刺共计283针,常规组系统穿刺共计1 200针,造影组单针阳性率显著高于常规组(P<0.001)。两组穿刺相关并发症差异均无统计学意义(P>0.05)。结论:经直肠CEUS引导下靶向穿刺在PCa的诊断中具有较高的检出率和单针阳性率,尤其在高龄和高PSA水平患者中优势明显,且安全性良好。Objective:To investigate the diagnostic efficacy of transrectal conventional ultrasound-guided systematic biopsy and transrectal contrast-enhanced ultrasonography (CEUS)-guided targeted biopsy for suspected prostate cancer (PCa).Methods:A total of 239 patients with suspected PCa who were admitted to Shanghai Fengxian District Central Hospital between February 2021 and February 2024 were selected.Among them,139 patients who underwent transrectal CEUS-guided targeted biopsy were included in the CEUS group.The conventional group included 100 patients who underwent transrectal conventional ultrasound-guided biopsy (12-core biopsy).The detection rates of PCa and clinically significant prostate cancer (CsPCa) in the two groups were compared.The detection rates of PCa in different subgroups were also analyzed.Core number,positive single-core count,and biopsy-related complications were compared between the two groups.Results:Biopsy confirmed PCa in 75 (53.96%) patients and benign lesions in 64 (46.04%) patients in the CEUS group.In the conventional group,38 (38.00%) patients had PCa,and 62 (62.00%) had benign lesions.The detection rate of PCa in the CEUS group was significantly higher than that in the conventional group (P<0.05).There were statistically significant differences in the detection rate of PCa between the different age groups and patients with different prostate specific antigen (PSA) levels in the CEUS group (P<0.05).Moreover,there were statistically significant differences in the detection rate of PCa between patients with different PSA levels in the conventional group (P<0.05).For patients aged>70 years,the PCa detection rate in the CEUS group was significantly higher than that in the conventional group (P<0.05).When the PSA level was>20 ng/mL,the PCa detection rate in the CEUS group was significantly higher than that in the conventional group(P<0.05).When the prostate volume was 31–60 cm~3,the detection rate of PCa in the CEUS group was significantly higher than that in the conventional group (P<0.05).T

关 键 词：前列腺癌 超声造影成像 靶向穿刺 经直肠穿刺活检 系统穿刺 诊断效能 

分 类 号：R737.25[医药卫生—肿瘤]