医药前沿
醫藥前沿
의약전연
YIAYAO QIANYAN
2014年
18期
63-64
,共2页
王尧%黄品同%刘春媚%张旭
王堯%黃品同%劉春媚%張旭
왕요%황품동%류춘미%장욱
超声检查%造影剂%活组织检查%前列腺肿瘤
超聲檢查%造影劑%活組織檢查%前列腺腫瘤
초성검사%조영제%활조직검사%전렬선종류
ultrasonography%Contrast agent%Biopsy%Prostate neoplasms
目的：探讨经直肠超声造影靶向引导穿刺在TRUS未发现病灶的可疑前列腺癌患者中的临床应用价值。方法：对64例血清前列腺特异抗原(PSA)升高(≥4.00ng/ml)且TRUS检查未发现病灶的患者进行经直肠超声造影(CE-TRUS)检查，检查后即刻在TRUS引导下，对每位患者前列腺的双侧底部、中部的内、外侧区和双侧前列腺尖部行10点系统穿刺以及CE-TRUS发现的异常区域行靶向穿刺，以穿刺病理结果为金标准，统计分析CE-TRUS图像结果和病理结果。结果：64例患者共穿刺701针，病理诊断前列腺癌14例(21.9%)，共80针(11.4%)。CE-TRUS发现异常者22例，其中前列腺癌9例，CE-TRUS诊断前列腺癌的敏感性、特异性、准确性分别为64.2%(9/14)、74.0%(37/50)、71.8%(46/64)；CE-TRUS靶向穿刺点的单针阳性率(50.8%)高于系统穿刺的(7.7%)(P<0.05)；CE-TRUS靶向穿刺检出癌灶的平均Gleason分值与系统穿刺活检检出癌灶平均Gleason分值之间无显著差异。结论：CE-TRUS技术有助于前列腺癌灶的检出，与系统穿刺法相比， CE-TRUS引导靶向穿刺法有更好的单针阳性率,但在病人检出率上，仍无法取代系统穿刺法。
目的：探討經直腸超聲造影靶嚮引導穿刺在TRUS未髮現病竈的可疑前列腺癌患者中的臨床應用價值。方法：對64例血清前列腺特異抗原(PSA)升高(≥4.00ng/ml)且TRUS檢查未髮現病竈的患者進行經直腸超聲造影(CE-TRUS)檢查，檢查後即刻在TRUS引導下，對每位患者前列腺的雙側底部、中部的內、外側區和雙側前列腺尖部行10點繫統穿刺以及CE-TRUS髮現的異常區域行靶嚮穿刺，以穿刺病理結果為金標準，統計分析CE-TRUS圖像結果和病理結果。結果：64例患者共穿刺701針，病理診斷前列腺癌14例(21.9%)，共80針(11.4%)。CE-TRUS髮現異常者22例，其中前列腺癌9例，CE-TRUS診斷前列腺癌的敏感性、特異性、準確性分彆為64.2%(9/14)、74.0%(37/50)、71.8%(46/64)；CE-TRUS靶嚮穿刺點的單針暘性率(50.8%)高于繫統穿刺的(7.7%)(P<0.05)；CE-TRUS靶嚮穿刺檢齣癌竈的平均Gleason分值與繫統穿刺活檢檢齣癌竈平均Gleason分值之間無顯著差異。結論：CE-TRUS技術有助于前列腺癌竈的檢齣，與繫統穿刺法相比， CE-TRUS引導靶嚮穿刺法有更好的單針暘性率,但在病人檢齣率上，仍無法取代繫統穿刺法。
목적：탐토경직장초성조영파향인도천자재TRUS미발현병조적가의전렬선암환자중적림상응용개치。방법：대64례혈청전렬선특이항원(PSA)승고(≥4.00ng/ml)차TRUS검사미발현병조적환자진행경직장초성조영(CE-TRUS)검사，검사후즉각재TRUS인도하，대매위환자전렬선적쌍측저부、중부적내、외측구화쌍측전렬선첨부행10점계통천자이급CE-TRUS발현적이상구역행파향천자，이천자병리결과위금표준，통계분석CE-TRUS도상결과화병리결과。결과：64례환자공천자701침，병리진단전렬선암14례(21.9%)，공80침(11.4%)。CE-TRUS발현이상자22례，기중전렬선암9례，CE-TRUS진단전렬선암적민감성、특이성、준학성분별위64.2%(9/14)、74.0%(37/50)、71.8%(46/64)；CE-TRUS파향천자점적단침양성솔(50.8%)고우계통천자적(7.7%)(P<0.05)；CE-TRUS파향천자검출암조적평균Gleason분치여계통천자활검검출암조평균Gleason분치지간무현저차이。결론：CE-TRUS기술유조우전렬선암조적검출，여계통천자법상비， CE-TRUS인도파향천자법유경호적단침양성솔,단재병인검출솔상，잉무법취대계통천자법。
Objective: To evaluate the value of contrast-enhanced transrectal ultrasonography(CE-TRUS)in detecting prostate cancer in patients with negative findings by transrectal ultrasonography (TRUS) .Methods: Sixty-four patients with elevated serum prostate-specific antigen (PSA) levels (more than 4.00 ng/mL ) but no abnormal findings by TRUS were evaluated with contrast-enhanced transrectal ultrasonography(CE-TRUS) , a 10-core systematic biopsy (SB) was subsequently taken at the base ,the mid and the apex gland and the targeted biopsy (TB)was taken at the foci found by CE-TRUS in each patient. Diagnostic efficiency of CE-TRUS for the cancer detection was evaluated .Cancer detection rates by the two techniques was also compared .Results: Prostate cancer was detected in 80 (11.4%)of 701 cores in 14(21.9%)of 64 patients.22 Patients showed abnormal image in CE-TRUS and 9 patients were diagnosed with prostate cancer , The sensitivity, specificity and overal accuracy for the detection of prostate cancer by CE-TRUS were 77.1%, 78.2%and 77.8%. Positive biopsy cores were more frequently obtained in 31 of 61 (50.8%) TB cores compared to 49 of 640 (7.7%) SB cores, while the mean Gleason score for CE-TRUS targeted biopsy was 6.8 and for systematic biopsy 6.6 (P>0.05). Conclusion: CE-TRUS enables excellent visualization of the prostate cancer with negative findings by transrectal ultrasonography (TRUS), and CE-TRUS targeted biopsy provides a significant benefit for the detection of prostate cancer, but systematic biopsies should not be eliminated on basis of many prostate cancers missed by CE-TRUS .
