经直肠超声联合前列腺特异性抗原密度检测对前列腺癌与前列腺增生的鉴别诊断价值

Differential diagnostic value of transrectal ultrasound combined with PSAD on prostate cancer and benign prostate hyperplsia

目的探讨经直肠超声联合前列腺特异性抗原密度（PSAD）检测对早期前列腺癌与前列腺增生的鉴别诊断价值。方法回顾性分析本院2009年5月—2012年6月收治的42例前列腺疾病患者的临床资料,入院后均接受经直肠超声联合PSAD鉴别诊断,后经前列腺穿刺活检或术后组织病理检查证实,其中前列腺癌19例设为PCa组,中重度前列腺增生23例设为BPH组。比较2组患者经直肠超声检测的声像特点和PSAD检测结果。结果 PCa组患者前列腺体积明显小于BPH组（P〈0.05）,异常血流信号发生率显著高于BPH组（P〈0.05）,但2组异常回声结节发生率无显著差异（P〉0.05）;PCa组患者PSAD值显著高于BPH组（P〈0.05）,〉0.2 ng/mL区段分布率显著高于BPH组,〈0.1 ng/mL区段分布率显著低于BPH组,2组0.1~0.2 ng/mL区段分布率无显著差异（P〉0.05）。结论异常血流信号是前列腺癌的直肠超声检测的声像特点,PSAD是前列腺癌的敏感预测指标,二者联合应用对前列腺癌与前列腺增生具有极高的鉴别诊断价值。

Objective To study and observe the differential diagnostic value of transrectal ultrasound combined with PSAD on early prostate cancer and benign prostate hyperplsia.Methods The clinical data of 42 patients with prostatic disorders treated in our hospital from May 2009 to June 2012 were analyzed retrospectively.All the patients received differential diagnosis of transrectal ultrasound combined with PSAD after admission.Through the examination and confirmation of prostate needle biopsy or postoperative pathology,19 patients with prostate cancer were set as PCa group and 23 patients with moderate to severe benign prostate hyperplsia were set as BPH group.The characteristics of transrectal ultrasound and test results of PSAD in 2 groups were compared.Results Prostate volume of PCa group was significantly larger than that of BPH group（P〈0.05）,and the incidence rate of abnormal blood flow signal in PCa group was significantly higher than that of BPH group（P〈0.05）.But there was no significant difference in the incidence rate of abnormal echo tubercle between two groups（P〈0.05）.And PSAD value in PCa group was significantly higher than that of BPH group（P〈0.05）.Section distribution rate with more than 0.2 ng/mL in PCa group was significantly higher than that of BPH group（P〈0.05）,and section distribution rate with less than 0.1 ng/mL was significantly lower than that of BPH group.And there was no significant difference in section distribution rate from 0.1 ng/mL to 0.2 ng/mL between two groups（P〈0.05）.Conclusion Abnormal blood flow sign is the characteristic of transrectal ultrasound for prostate cancer and PSAD is a sensitive predictor of prostate cancer.The combination application of them has high differential diagnosis value on prostate cancer and benign prostate hyperplsia.