前列腺癌超声造影、活检受侵范围与病理新分级分组的相关性

Correlation Between Invasion Range of Contrast-Enhanced Ultrasound, Biopsy Specimens and the New Pathological Classification of Prostate Cancer

目的 探讨前列腺癌超声造影、穿刺活检标本受侵范围与病理新分级分组的相关性。资料与方法 回顾性分析2019年1月—2020年6月广西医科大学第一附属医院泌尿外科收治且经直肠前列腺超声造影有异常发现的94例患者,均经穿刺活检病理证实为前列腺腺癌。收集患者血清前列腺特异抗原、病灶超声造影增强程度、定量参数峰值强度(PI)、穿刺活检标本受侵范围(包括穿刺阳性针数占总针数的比例、全部活检标本肿瘤所占平均比例、受累最重的活检标本肿瘤所占最大比例)、全部活检标本肿瘤病理新分级分组情况。结果 超声造影呈高增强组67例,低增强组27例。高增强组穿刺阳性针数占比、受累最重的活检标本肿瘤最大占比和病理新分级分组均高于低增强组(t=-3.719、-4.312、-2.401,P均<0.05)。低增强组PI与新分级分组呈正相关(r=0.774,P=0.003);高增强组PI与新分级分组无相关性(P=0.384)。结论 超声造影呈高增强的前列腺癌穿刺阳性标本受侵范围更大,病理新分级分组更高,预后更差。超声造影呈低增强的癌灶,PI值越高,提示预后越差;但超声造影呈高增强的癌灶,PI值并不能很好地反映其预后。

Purpose To investigate the correlation between the invasion range of contrast-enhanced ultrasound, biopsy specimens and the new pathological classification of prostate cancer. Materials and Methods From January 2019 to June 2020, 94 patients who were admitted to the department of urology, the First Affiliated Hospital of Guangxi Medical University, with abnormal findings of transrectal contrast enhanced ultrasound were retrospectively analyzed. All patients were confirmed as prostate adenocarcinoma by biopsy. The patient’s serum prostate specific antigen(prostate specific antigen, PSA), enhanced mode of CEUS, peak intensity(PI), invasion range of biopsy specimens(including the ratio of the number of positive needles to the total number of needles, all the average proportion of tumors in biopsy specimens,the largest proportion of tumors in the most affected biopsy specimens), and new pathological grading were collected. Results There were 67 cases in high contrast-enhanced group and 27 cases in low contrast-enhanced group. In the high enhancement group, the proportion of positive puncture needles, the largest proportion of the most seriously involved biopsy specimens and the new pathological grade group were higher than those in the low enhancement group(t=-3.719,-4.312,-2.401;all P<0.05). In the low enhancement group, PI was positively correlated with the new classification group(r=0.774 P=0.003). In the high enhancement group, PI was not correlated with the new classification group(P=0.384). Conclusion Prostate cancer with high contrast-enhanced ultrasound has a larger invasion range, higher pathological classification and worse prognosis. It is suggested that a higher PI could represent a higher new pathological grade group and a worse prognosis, if the tumor shows low enhancement. However, PI value is not correlated with the new pathological grade group, if the tumor shows high enhancement.