CAJ | 학술논문

目的：系统地观察及探讨经直肠超声（ TRUS）及超声引导下穿刺对前列腺肿大病变患者超声图像特征及前列腺癌（ PCa）的前列腺特异性抗原（ PSA）及临床分期超声表现特征。方法应用经直肠彩色多普勒超声对临床拟诊为PCa患者进行检查，然后经直肠超声引导下前列腺穿刺，方法为系统6点加可疑结节处穿刺法；与血清PSA及病理结果对照；并将前列腺癌血清PSA、穿刺活检阳性百分数（ PPBCs）、Gleason评分与临床分期进行对照比较。结果经病理证实413例中PCa 149例，前列腺增生171例，增生并炎症44例，增生并上皮内瘤（ PIN）、非典型增生（ AAH）共49例。前列腺癌与临床（ Whitmore-Jewett法） A、B、C、D分期对照有一定的临床分期的超声声像图特征性表现，不同PCa临床分期的TRUS声像图特点：血清PSA、PPBCs及Gleason评分三者分别与PCa临床分期呈显著正相关。结论经直肠彩色多普勒超声能清晰显示前列腺内部结构，前列腺病变尤其是前列腺癌超声声像图有一定的特征性表现，结合PSA有助于提高前列腺病变诊断水平。
목적：계통지관찰급탐토경직장초성（ TRUS）급초성인도하천자대전렬선종대병변환자초성도상특정급전렬선암（ PCa）적전렬선특이성항원（ PSA）급림상분기초성표현특정。방법응용경직장채색다보륵초성대림상의진위PCa환자진행검사，연후경직장초성인도하전렬선천자，방법위계통6점가가의결절처천자법；여혈청PSA급병리결과대조；병장전렬선암혈청PSA、천자활검양성백분수（ PPBCs）、Gleason평분여림상분기진행대조비교。결과경병리증실413례중PCa 149례，전렬선증생171례，증생병염증44례，증생병상피내류（ PIN）、비전형증생（ AAH）공49례。전렬선암여림상（ Whitmore-Jewett법） A、B、C、D분기대조유일정적림상분기적초성성상도특정성표현，불동PCa림상분기적TRUS성상도특점：혈청PSA、PPBCs급Gleason평분삼자분별여PCa림상분기정현저정상관。결론경직장채색다보륵초성능청석현시전렬선내부결구，전렬선병변우기시전렬선암초성성상도유일정적특정성표현，결합PSA유조우제고전렬선병변진단수평。
Objective To observe and explore the characteristics of ultrasonography for transrectal color Doppler ultrasound in the diagnosis of hypertophy of the prostate disease and specific antigen( PSA) and image fea-tures in clinical stages of prostate cancer( PCa)systematically.Methods Patients clinically suspected of PCa under -went prostate exam by transrectal color doppler ultrasound, then by transrectal ultrasound guided prostate biopsy by 6 points adding suspected nodes method,comparing with the PSA, pathologic results, PPBCs, Gleason score, and clin-ical stages.Results In 413 patients confirmed by pathology(149 PCa, 171 BPH, 44 BPH with inflammation, 49 BPH with PIN and AAH), prostate disease had some characteristic ultrasound images.Clinical stages A,B,C or D ( Whitmore-Jewett methods) of PCa had some different characteristics of ultrasound images.The results showed that PSA, PPBCs and Gleason grades were positively correlated with PCa stages respectively.Conclusion Transrectal color Doppler ultrasound not only clearly reveals the internal structure of prostate ,but also has the characteristic ultra-sound imaging.Combination of image features with PSA is helpful for improving the diagnosis of prostate disease .