前列腺癌超声表现与Gleason评分的关系

Relationship Between Ultrasonic Manifestations in Prostate Cancer and Gleason Score

目的探讨前列腺癌(PCa)超声表现与Gleason评分的关系,提高经直肠超声(TRUS)检查PCa的临床价值。资料与方法回顾性分析2009年9月-2015年1月于苏州大学附属第一医院就诊的362例PCa患者资料,TRUS检查将PCa的超声表现分为局限性、弥漫性及阴性3种类型,病理组织Gleason评分将PCa危险度分为低危(<7分)、中危(=7分)、高危(>7分)3个等级。分析PCa的超声表现与危险度之间的关系。结果超声检查发现,362例PCa患者中,超声阴性表现占32.9%(119/362),超声阳性表现占67.1%(243/362),其中局限性38.7%(140/362),弥漫性28.4%(103/362)。局限性和弥漫性表现PCa中,高危组患者数均显著多于低危组,高、中、低危组间差异有统计学意义(P<0.05)。低危组中超声阴性表现多于阳性表现,差异有统计学意义(P<0.05);高危组中局限性和弥漫性表现多于阴性表现,差异有统计学意义(P<0.05)。结论 TRUS在PCa的诊治中有较高的临床价值,超声阳性表现能初步评估PCa的危险度。

Purpose To investigate the relationship between ultrasonic manifestations in prostate cancer（PCa） and Gleason score, and improve the clinical value of transrectal ultrasound（TRUS） examination of PCa. Materials and Methods 362 patients with PCa treated in the First Affiliated Hospital of Soochow University from September 2009 to January 2015 were analyzed retrospectively, according to TRUS examination, the ultrasonic manifestations of PCa were divided into the localized type, diffuse type and negative type. Gleason score of pathological tissue divided the risk factor of PCa into low risk（〉7 points）, medium risk（=7 points）, and high risk（〉7 points）. The relationship between ultrasonic manifestations of PCa and risk factor was analyzed. Results Ultrasonic results showed that, for the 362 patients with PCa, patients with ultrasonic negative manifestations accounted for 32.9%（119/362） and those with ultrasonic positive manifestations accounted for 67.1%（243/362）, including 38.7%（140/362） localized type and 28.4%（103/362） diffuse type. In localized and diffuse PCa, the number of patients in high risk group was significantly more than the low risk group, and the difference among the high risk, medium risk and low risk groups was statistically significant（P〈0.05）; in the low risk group, the ultrasonic negative manifestations were more than the positive manifestations, and the difference was statistically significant（P〈0.05）; in high risk group, the localized and diffuse manifestations were more than the negative manifestations and the difference was statistically significant（P〈0.05）. Conclusion TRUS shows more clinical values in the diagnosis and treatment of PCa, and the ultrasonic positive manifestations can preliminarily evaluate the risk factor of PCa.