摘要
目的 探讨经直肠实时组织弹性成像(TRTE)联合峰值应变指数(PSI)靶向穿刺活检诊断外周带前列腺癌的应用价值。方法 选取于我院就诊的127例疑似外周带前列腺癌患者,均行经直肠超声(TRUS)和TRTE检查,计算PSI;然后行TRUS系统穿刺活检、TRTE联合PSI靶向穿刺活检,根据手术病理结果分为前列腺癌组92例和良性病变组35例,比较两组PSI和各临床资料的差异;比较TRUS系统穿刺活检与TRTE联合PSI靶向穿刺活检对外周带前列腺癌的检出率及穿刺点阳性率;绘制受试者工作特征(ROC)曲线分析TRTE联合PSI靶向穿刺活检对外周带前列腺癌的诊断效能。结果 前列腺癌组PSI、血清前列腺特异性抗原(PSA)均高于良性病变组,差异均有统计学意义(均P<0.001)。92例外周带前列腺癌患者中,TRTE联合PSI靶向穿刺活检诊断85例,TRUS系统穿刺活检诊断78例,二者对外周带前列腺癌的检出率比较(66.9%vs. 61.4%),差异无统计学意义。127例患者共穿刺1524针,其中TRUS系统穿刺1270针,TRTE联合PSI靶向穿刺254针,二者穿刺点阳性率比较(17.9%vs. 51.9%),差异有统计学意义(P<0.01)。ROC曲线分析显示,PSI以9.72为截断值,TRTE联合PSI靶向穿刺活检诊断外周带前列腺癌的曲线下面积为0.923(95%可信区间:0.879~0.967),灵敏度、特异度分别为92.39%、88.57%;进一步研究表明,当血清PSA≥20 ng/ml时,TRTE联合PSI靶向穿刺活检诊断外周带前列腺癌的灵敏度、特异度分别为96.88%、83.33%。结论 TRTE联合PSI靶向穿刺活检在外周带前列腺癌的诊断中具有较好的临床应用价值。
Objective To investigate the application value of transrectal real-time tissue elastography(TRTE)combined with peak strain index(PSI) targeted puncture biopsy in the diagnosis of peripheral zone prostate cancer.Methods A total of 127 patients with suspected peripheral zone prostate cancer attending our hospital were selected,and all underwent transrectal ultrasound(TRUS) and TRTE,the PSI was calculated,then all underwent TRUS system puncture biopsy,TRTE combined with PSI targeted puncture biopsy,and the patients were divided into 92 cases in the prostate cancer group and 35cases in the benign lesion group according to the surgical pathology re sults.The differences in PSI and clinical data between the two groups were compared.The detection rate and puncture site positive rate of peripheral zone prostate cancer by TRUS system puncture biopsy and with TRTE combined were compared.The diagnostic efficacy of TRTE combined with PSI targeted puncture biopsy for prostate cancer in the peripheral zone was evaluated by receiver operating characteristic(ROC) curve.Results PSI and serum prostate specific antigen(PSA) in the prostate cancer group were higher than those in the benign lesion group,and the differences were statistically significant(both P<0.001).Among 92 patients with peripheral zone prostate cancer,85 cases were diagnosed by TRTE combined with PSI-targeted puncture biopsy and 78 cases were diagnosed by TRUS system puncture biopsy,and there was no statistically significant difference in the detection rate of peripheral zone prostate cancer between the two groups(66.9% vs.61.4%).A total of 1524 punctures were performed in 127 patients,including 1270 punctures with the TRUS system and 254 punctures with TRTE combined with PSI-targeted,and the difference of positive rate of puncture sites between the two groups was statistically significant(17.9% vs.51.9%,P<0.01).ROC curve analysis showed that PSI with a cut-off value of 9.72,the area under the curve of TRTE combined with PSI-targeted puncture biopsy in the diagnosis of peripheral zone prostate cancer was 0.923(95% confidence interval:0.879~0.967),with a sensitivity and specificity of 92.39% and 88.57%,respectively.When the serum PSA≥20 ng/ml,the sensitivity and specificity of TRTE combined with PSI-targeted puncture biopsy in the diagnosis of peripheral zone prostate cancer were 96.88% and 83.33%,respectively.Conclusion TRTE combined with PSItargeted puncture biopsy is clinically useful in diagnosing peripheral zone prostate cancer.
作者
王琳
宣之东
WANG Lin;XUAN Zhidong(Department Three of Ultrasound,Cangzhou Central Hospital,Hebei 061000,China)
出处
《临床超声医学杂志》
CSCD
2023年第1期49-53,共5页
Journal of Clinical Ultrasound in Medicine
关键词
超声检查
经直肠
实时组织弹性成像
活检
前列腺癌
Ultrasonography
transrectal
Real-time tissue elastography
Biopsy
Prostate cancer
