剪切波弹性成像测定弹性模量值与前列腺癌病变程度和Gleason评分的相关性分析

The relationship of the elasticity modulus value of SWE with the lesion degree of PCa and with Gleason score

目的:分析剪切波弹性成像(SWE)测定弹性模量最大值(E_(max)值)、平均值(E_(mea)值)与前列腺癌患者病变程度,以及与患者前列腺癌Gleason分级的关系。方法:选取医院收治的106例前列腺病变患者,依照前列腺穿刺活检结果将其分为前列腺癌组(43例)和良性病变组(63例);采用SWE超声检查评估弹性模量E_(max)值、E_(mea)值;绘制受试者工作特征(ROC)曲线,分析E_(max)值及E_(mea)值对前列腺癌的鉴别诊断结果,采用logistics回归模型分析E_(max)值、E_(mea)值与前列腺癌Gleason分级的关系。结果:前列腺癌组患者的E_(max)值及E_(mea)值均明显高于良性病变组,且差异有统计学意义(t=6.767,t=5.505;P<0.05);E_(max)值及E_(mea)值鉴别前列腺癌的灵敏度和特异度分别为90.70%和86.05%,且ROC曲线下面积(AUC)均高于0.9;不同患者Gleason评分E_(max)值及E_(mea)值存明显差异,其中≥9分E_(max)值及E_(mea)值最高,4~6分E_(max)值及E_(mea)值最低,且差异均有统计学意义(t=5.358,t=6.062;P<0.05);E_(max)值及E_(mea)值是影响患者前列腺癌Gleason评分的独立性影响因素。结论:SWE测定E_(max)值、E_(mea)值可有效鉴别前列腺癌,SWE也是影响患者前列腺癌Gleason评分的独立性影响因素。

Objective:To analyze the relationships of the E_(max)value and Emea value of elasticity modulus,which was determined by shear wave elastography(SWE),with the lesion degree of patients with prostatic cancer(PCa)and with the Gleason grading.Methods:106 patients with prostatic lesion who admitted to hospital were selected and were divided into PCa group(43 cases)and benign lesion group(63 cases)according to the results of aspiration biopsy on prostate.SWE ultrasound examination was adopted to assess E_(max)value and Emea value of elasticity modulus.And the receiver operating characteristics(ROC)curve was drawn to analyze the differentially diagnostic results of E_(max)and Emea for PCa.And the Logistics regression model was adopted to analyze the relationships of E_(max)value and Emea value with Gleason grading.Results:The E_(max)value and Emea value of patients in the PCa group were significantly higher than those of benign lesion group(t=6.767,t=5.505,P<0.05).And the sensitivity and specificity of the E_(max)value and Emea value were 90.70%and 86.05%in identifying PCa,respectively.And the area under curve(AUC)of ROC curve both of them were higher than 0.9.There were significant differences of E_(max)value and Emea value of different Gleason scores,and the E_(max)value and Emea value of≥9 scores were highest,and those of 4-6 scores were lowest,and the difference of those between them were significant(t=5.358,t=6.062,P<0.05).E_(max)value and Emea value were independent influence factors that affected the Gleason score of PCa patients.Conclusion:The determined E_(max)value and Emea value by SWE can effectively identify PCa,and it is also an independent influencing factor that affects Gleason score of patient.