前列腺癌病灶的直径与形态特征在评估前列腺癌外浸润中的临床意义

Clinical value of lesion diameter and morphological characteristics in evaluating prostate cancer extraprostatic invasion

目的经直肠超声观察前列腺癌声像图特征,并测量大小来评估前列腺外侵犯及骨转移情况。方法经直肠超声观察94例前列腺癌患者前列腺内病灶声像图特征,检测病灶大小来分组评估前列腺外侵犯及骨转移阳性例数,并进一步分析不同肿瘤大小分组诊断的敏感性及特异性。结果随着肿瘤增大,其回声更杂乱,血供更丰富,恶性度更高,向周围浸润及远处骨转移趋势更强,29例出现前列腺外侵犯,24例出现骨转移,肿瘤大于3cm或大于4cm时诊断前列腺外侵犯及骨转移的敏感性及特异性均较高,尤其大于4cm时诊断前列腺外侵犯敏感性为87.1%,骨转移敏感性为54.2%,但肿瘤大于3cm较大于4cm时诊断前列腺外侵犯特异性较高为91.9%;诊断骨转移特异性以肿瘤大于4cm时最高为81.4%。结论经直肠超声能清晰显示前列腺内癌灶,所测量前列腺癌灶大小能够较好评估前列腺外侵犯、骨转移的情况,并可对分期做进一步补充。

Objective To observe the sonogram features of prostate cancer by transrectal ultrasound （ TRUS）, and to evaluate the extraprostatic invasion and bone metastasis by measuring lesions size. Methods Ninety - four patients with prostate cancer were enrolled in this study. The uhrasonographic features of prostate cancer lesions were mainly observed by TRUS, the case number of extraprostatic invasion and bone metastases were evaluated in the groups with different lesion size, and the diagnostic sensitivity and specificity of different lesion size were analyzed. Results With the lesion increased, the echo was more indiscriminate, blood supply was more abundant, the malignant degree was higher, and the metastatic tendency was stronger. In 94 patients, there were 29 cases of extraprostatic invasion ,24 cases of bone metastasis. When lesion size was more than 3 cm or more than 4 cm,the diagnostic specificity and sensitivity of extraprostatic invasion and bone metastases were higher, especially for the lesion size was more than 4 cm, the diagnostic sensitivity of extraprostatic invasion and bone metastasis was 87.1% and 54.2% , respectively. While for the lesion size was more than 3cm, the diagnostic specificity of extraprostatic invasion and bone metastases was 91.9% and 81.4%, respectively. Conclusion Transrectal ultrasound can clearly display the lesions of prostate cancer, and the lesion size can evaluate extraprostatic invasion and bone metastases effectively which can supply for the staging.