经直肠超声造影诊断前列腺癌的临床价值

Clinical value for contrast-enhanced transrectal ultrasound in diagnosis of prostate cancer

目的:探讨经直肠超声造影(contrast-enhanced transrectal ultrasound,CETRUS)诊断前列腺癌的优势。方法:2013年1月至2015年3月因疑似前列腺癌来湖南省长沙市中心医院就诊的拟行超声引导下前列腺穿刺活检术的患者207例,按就诊顺序随机被分为造影组(n=104)和非造影组(n=103)。两组患者均首选经直肠超声检查(transrectal ultrasonography,TRUS),造影组再进行CETRUS检查。两组患者均经直肠进行穿刺活检,以病理检查结果为金标准,评估CETRUS在前列腺癌诊断中的价值。结果:TRUS诊断前列腺癌的敏感性、特异性、符合率分别为65%,60.4%和62.8%。CETRUS诊断前列腺癌的敏感性、特异性、符合率分别为89%,78%和84%。两者相比差异均有统计学意义(均P<0.05)。结论:CETRUS诊断前列腺癌的敏感性、特异性及符合率均较TRUS高,可以为前列腺癌的诊断及鉴别诊断提供临床依据。

Objective： To explore the value for contrast-enhanced transrectal ultrasound （CETRUS） in the diagnosis of prostate cancer. Methods： Prostate biopsy from 207 cases of suspected prostate cancer were collected between January 2013 and March 2015. These patients were performed ultrasound-guided prostate biopsy in Central Hospital of Changsha. They were randomly divided into a radiography group （n= 104） and a non-radiography group （n= 103） according to the order of treatment. Transrectal ultrasonography （TRUS） was the first choice in the 2 groups, and CETRUS was conducted in the radiography group. Then, the transrectal biopsy was carried out in the 2 groups, q-he diagnostic value of CETRUS in prostate cancer was evaluated by pathological examination, a gold standard.Results： The sensitivity,specificity, and coincidence rates of TRUS in diagnosing prostate cancer were 65%, 60.4%, and 62.8%, respectively, while those rates of CETRUS in diagnosing prostate cancer were 89%, 78%, and 84%, respectively, with significant difference between the above 2 groups （all P〈0.05）. Conclusion： The sensitivities, specificities, and coincidence rates for CETRUS are superior to TRUS in diagnosing prostate cancer, which can provide a clinical basis for the diagnosis and differential diagnosis of prostate cancer.