经直肠实时组织弹性成像评分法与比值法对前列腺癌的诊断价值的比较

Comparison of ratio method and score method in the diagnosis of prostate cancer with transrectal real-time tissue elastography

目的:比较经直肠实时组织弹性成像(TRTE)评分法与比值法对前列腺癌(PCa)的诊断价值。方法:观察67例疑诊为PCa患者经直肠超声二维及弹性成像表现,并对结节进行弹性评分及应变指数(SI)的测量,构建受试者工作特征(ROC)曲线来确定SI的诊断点,与病理结果对照分析TRTE评分法及比值法对PCa的诊断价值。结果:TRTE比值法显示良恶性病灶SI值之间,差异有统计学意义(P<0.05)。与直肠指检(DRE)及常规经直肠超声(TRUS)诊断的敏感性、特异性、准确性比较,TRTE比值法与二者的差异均有统计学意义(P<0.05),评分法与TRUS的差异无统计学意义(P>0.05)。评分法与比值法之间比较,其敏感性、特异性及准确性的差异有统计学意义(P<0.05)。结论:TRTE可提高PCa的诊断率,TRTE比值法为PCa的诊断提供相对客观、可靠的信息。

Objective： To compare score method and ratio method in the diagnosis of prostate cancer（19Ca） with transrectal real-time tissue elastography（TRTE）. Methods： Sixty-seven patients suspected of PCa were examined with two-dimensional and elastosonography. Elastography score and strain index（SI） of the nodules were calculated. The curves of receiver operating char- acteristic（ROC） were built to find the diagnostic point. The value of TRTE score method and the ratio method in the diagnosis of PCa were analyzed compared with pathological results. Results： TRTE ratio method showed a significant difference of SI between benign and malignant nodules（P〈0.05）. Compared with digital rectal examination（DRE） and transrectal ultrasonography （TRUS）, TRTE ratio method had statistical significance in .diagnostic sensitivity, specificity, and accuracy and the two methods above （P〈0.05）, but there was no significant difference between score method and TRUS （P〉0.05）. The difference of diagnostic sensitivity, specificity, accuracy was statistically significant between score method and ratio method（P〈0.05）. Conclusion： TRTE ean increase the diagnostic rate of PCa, and the ratio method provides a more objective and valuable information for the diagnosis of PCa.