CAJ | 학술논문

目的：探讨PSA 灰区值时，MRI+MRS 在早期诊断前列腺癌中临床意义。方法对92例PSA4-10ng/ml 患者行MRI+MRS检查，对MRI 异常和（或）MRS 检查(胆碱+肌酸)/枸橼酸盐(Cho+Cre/Cit)≥0.75患者进行前列腺穿刺活检，MRI+MRS无异常者，有手术指征行前列腺电切术，术后行病理检查，无手术指征定期随访。结果73例MRI异常和（或）Cho+Cre/Cit≥0.75穿刺后，12例前列腺癌，其中1例前列腺癌患者MRI示前列腺肿瘤已侵及前列腺包膜，19例MRI+MRS无异常者术后病理1例前列腺癌。阳性组(前列腺癌组）Cho+Cre/Cit值与阴性组（前列腺增生）相比差异显著（P＜0.05)。结论 PSA4-10ng/ml前列腺增生患者，常规行MRI+MRS，有助于前列腺癌早期诊断及临床分期，以Cho+Cre/Cit≥1.29为穿刺的最佳临界值，但有待大样本研究进一步证实及界定。
목적：탐토PSA 회구치시，MRI+MRS 재조기진단전렬선암중림상의의。방법대92례PSA4-10ng/ml 환자행MRI+MRS검사，대MRI 이상화（혹）MRS 검사(담감+기산)/구연산염(Cho+Cre/Cit)≥0.75환자진행전렬선천자활검，MRI+MRS무이상자，유수술지정행전렬선전절술，술후행병리검사，무수술지정정기수방。결과73례MRI이상화（혹）Cho+Cre/Cit≥0.75천자후，12례전렬선암，기중1례전렬선암환자MRI시전렬선종류이침급전렬선포막，19례MRI+MRS무이상자술후병리1례전렬선암。양성조(전렬선암조）Cho+Cre/Cit치여음성조（전렬선증생）상비차이현저（P＜0.05)。결론 PSA4-10ng/ml전렬선증생환자，상규행MRI+MRS，유조우전렬선암조기진단급림상분기，이Cho+Cre/Cit≥1.29위천자적최가림계치，단유대대양본연구진일보증실급계정。
Objective To discuss MRI+MRS clinical significance for the early diagnosis of prostate cancer When PSA in a gray zone. Methods 92 patients whose PSA was 4-10ng/ml underwent MRI+MRS examination,those patients whose MRI(or) MRS was abnormal[(choline+creatine)/citrate(Cho+Cre/Cit)≥0.75] underwent prostate biopsy,other patients whose MRI+MRS was normal underwent transurethral resection of the prostate if they have the operation indications,and pathological examination after opera-tion. We follow up the patients without operation indication. Results 73 patients with Cho+Cre/Cit≥0.75 underwent puncture,12 cases of prostate cancer,One example of prostate cancer MRI showed the tumor has invaded the prostate capsule,and 1 patient of prostate cancer in 19 cases of normal MRI+MRS. Positive group (prostate cancer) Cho+Cre/Cit value and negative (benign prostatic hyperplasia) compared to the significant difference (P<0.05). Conclusion The patients with PSA4-10ng/ml underwent routine MRI+MRS,which contribute to the early diagnosis of prostate cancer and clinical stage,the best critical value of prostate biopsy is Cho+Cre/Cit≥1.29,but the conclusion must be confirmed and defined through a large sample study further.