经直肠超声造影引导前列腺穿刺活检诊断前列腺癌

Contrast-enhanced transrectal ultrasonography in guiding prostate biopsy for diagnosis of prostate cancer

目的探讨经直肠超声造影(CETRUS)引导前列腺穿刺活检对前列腺癌的诊断价值。方法对79例可疑前列腺癌患者分别行常规经直肠超声(TRUS)、CETRUS及经直肠前列腺穿刺活检。以病理结果为标准,对比TRUS、CETRUS和TRUS联合CETRUS引导经直肠前列腺穿刺活检对前列腺癌的诊断效能。结果79例中,病理诊断为前列腺腺癌36例,前列腺良性增生43例。35例CETRUS见异常征象,其中30例病理诊断恶性,诊断敏感度83.33%(30/36),特异性88.37%(38/43),准确率86.08%(68/79)。39例TRUS见异常征象,其中24例病理诊断为恶性病变,诊断敏感度66.67%(24/36),特异度65.12%(28/43),准确率65.82%(52/79)。TRUS联合CETRUS诊断前列腺癌30例,敏感度83.33%(30/36),特异度72.09%(31/43),准确率77.22%(61/79)。ROC曲线结果显示,TRUS、CETRUS、TRUS联合CETRUS引导前列腺穿刺活检对诊断前列腺癌的AUC分别为0.740、0.859及0.777,CETRUS的诊断效能高于TRUS及TRUS联合CETRUS(Z=2.371、2.858,P=0.018、0.004)。结论CETRUS引导前列腺穿刺活检对前列腺癌的诊断效能较高。

Objective To explore the value of contrast-enhanced transrectal ultrasonography(CETRUS)in guiding prostate biopsy for diagnosis of prostate cancer(PCa).Methods Transrectal ultrasound(TRUS),CETRUS and transrectal prostate biopsy were performed in 79 patients with suspected PCa.The diagnosed efficiency of TRUS,CETRUS and TRUS combined CETRUS were compared and taken pathology results as diagnostic criteria.Results Among 79 patients,PCa was pathologically diagnosed in 36 cases,while benign prostatic hyperplasia was diagnosed in 43 cases.Pathology results proved PCa in 30 patients among 35 patients with abnormal CETRUS,and the sensitivity,specificity and accuracy of CETRUS for diagnosing PCa was 83.33%(30/36),88.37%(38/43)and 86.08%(68/79),respectively.Pathology results proved PCa in 24 patients among 39 patients with abnormal TRUS,and the sensitivity,specificity and accuracy of TRUS for diagnosing PCa was 66.67%(24/36),65.12%(28/43)and 65.82%(52/79),respectively.Thirty cases of PCa were diagnosed with TRUS combined CETRUS,and the sensitivity,specificity and accuracy was 83.33%(30/36),72.09%(31/43)and 77.22%(61/79),respectively.ROC curve analysis showed that the AUC of TRUS,CETRUS and TRUS combined CETRUS was 0.740,0.859 and 0.777,respectvely.The diagnostic efficiency of CETRUS was higher than that of TRUS(Z=2.371,P=0.018)and TRUS combined CETRUS(Z=2.858,P=0.004).Conclusion The diagnostic efficiency of CETRUS is high for guiding transrectal prostate biopsy to diagnose PCa.