中华肿瘤防治杂志2024，Vol.31Issue(12) ：752-758.DOI:10.16073/j.cnki.cjcpt.2024.12.06

经直肠超声系统穿刺联合超微血管成像技术靶向穿刺在前列腺癌诊断中的应用

Application of transrectal ultrasound system puncture combined with superb microvascular imaging technique targeted puncture in the diagnosis of prostate cancer

何竹 江泉 张渊 单君 傅宇 周丽 陈珑
中华肿瘤防治杂志2024，Vol.31Issue(12) ：752-758.DOI:10.16073/j.cnki.cjcpt.2024.12.06
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经直肠超声系统穿刺联合超微血管成像技术靶向穿刺在前列腺癌诊断中的应用

Application of transrectal ultrasound system puncture combined with superb microvascular imaging technique targeted puncture in the diagnosis of prostate cancer

何竹 1江泉 1张渊 1单君 1傅宇 1周丽 1陈珑2
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作者信息

  • 1. 上海市浦东新区人民医院超声科,上海 201299
  • 2. 苏州大学附属第一医院介入放射科,江苏苏州 215006
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摘要

目的 探讨经直肠超声(TRUS)系统穿刺联合超微血管成像(SMI)靶向穿刺在可疑前列腺癌诊断中的应用价值.方法 回顾性选取2021-06-01-2023-02-28上海市浦东新区人民医院临床诊断为可疑前列腺癌,但在常规灰阶超声未发现可疑前列腺恶性病灶的患者共150例.按穿刺活检使用的超声引导技术分为3组:TRUS引导下系统穿刺活检联合超微血管成像(SMI)靶向穿刺活检组(TRUS+SMI组)52例,TRUS引导下系统穿刺活检联合超声造影(CEUS)靶向穿刺活检组(TRUS+CEUS组)54例,单独TRUS引导下系统穿刺活检组(TRUS组)44例.以手术病理结果或≥6个月临床随访结果为金标准,通过x2检验或Fisher精确概率法分析,评估3种方法引导下的经皮穿刺活检对前列腺癌的诊断效能.结果 TRUS+SMI组中前列腺癌16例,而穿刺活检病理诊断15例为前列腺癌,漏诊1例,检出率为28.85％(15/52);TRUS+CEUS组中前列腺癌14例,而穿刺活检病理诊断13例为前列腺癌,漏诊1例,检出率为24.07％(13/54);单独TRUS组中前列腺癌13例,但穿刺活检病理仅诊断出7例为前列腺癌,漏诊6例,检出率为15.91％(7/44).TRUS+SMI组、TRUS+CEUS组、单独TRUS组行穿刺活检的诊断准确度分别为98.08％(51/52)、98.15％(53/54)和 86.36％(38/44),灵敏度分别为 93.75％(15/16)、92.86％(13/14)和 53.85％(7/13),差异均有统计学意义(P值分别为0.018和0.013),但组间两两比较差异无统计学意义,均P＞0.017;3组穿刺活检的特异度均为100.00％.结论 TRUS系统穿刺联合SMI靶向穿刺对前列腺癌的诊断灵敏度及准确度均高于单独TRUS引导下的系统穿刺,而与TRUS系统穿刺联合CEUS靶向穿刺对前列腺癌的诊断效能相近.TRUS系统穿刺联合SMI靶向穿刺能有效诊断前列腺癌.

Abstract

Objective To investigate the application value of transrectal ultrasound(TRUS)system puncture combined with superb microvascular imaging(SMI)targeted puncture in the diagnosis of suspected prostate cancer.Methods A total of 150 patients who were clinically diagnosed with suspected prostate cancer by Shanghai Pudong New Area People's Hospi-tal from June 1,2021 to February 28,2023 were retrospectively selected,but no suspected malignant lesions of prostate were found by routine grayscale ultrasound.The patients were divided into three groups according to the different ultra-sound guidance techniques used for puncture biopsy:52 cases were in the TRUS-guided systematic puncture biopsy com-bined with SMI targeted puncture biopsy group(TRUS+SMI group),54 cases in the TRUS-guided systematic puncture biopsy combined with contrast-enhance ultrasound(CEUS)targeted puncture biopsy group(TRUS+CEUS group),and 44 cases in the TRUS-guided systematic puncture biopsy group(TRUS group)alone.Surgical pathologic results or clinical follow-up results of ≥6 months were used as the gold standard,x2 test or Fisher exact probability method were used to evaluate the diagnostic efficacy of three methods guided percutaneous puncture biopsy for prostate cancer.Results In the TRUS+SMI group,16 cases were diagnosed as prostate cancer,while 15 cases were pathologically diagnosed as prostate cancer by puncture biopsy,and 1 case was missed,the detection rate was 28.85％(15/52).In the TRUS+CEUS group,there were 14 cases of prostate cancer,while 13 cases were pathologically diagnosed as prostate cancer by puncture biopsy,and 1 case was missed,the detection rate was 24.07％(13/54).In the TRUS group alone,there were 13 cases of prostate cancer,but only 7 cases were pathologically diagnosed as prostate cancer by puncture biopsy,and 6 cases were missed,the detection rate was 15.91％(7/44).The diagnostic accuracy of puncture biopsy in TRUS+SMI group,TRUS+CEUS group and TRUS group alone was 98.08％(51/52),98.15％(53/54)and 86.36％(38/44),re-spectively,the diagnostic sensitivity was 93.75％(15/16),92.86％(13/14),53.85％(7/13),respectively,and the differences were statistically significant(P=0.018,P=0.013),but pairwise comparison between groups had no statisti-cal difference(P＞0.017).The specificity of puncture biopsy in three groups was 100.00％.Conclusions The diagnostic sensitivity and accuracy of TRUS guided system puncture biopsy combined with SMI targeted puncture biopsy for prostate cancer are higher than that of TRUS guided system puncture biopsy alone,and the diagnostic efficacy of TRUS guided system puncture biopsy combined with SMI targeted puncture biopsy was similar with that of TRUS system puncture bi-opsy combined with CEUS targeted puncture biopsy for prostate cancer.TRUS system puncture combined with SMI tar-geted puncture can effectively diagnose prostate cancer.

关键词

前列腺癌/超微血管成像技术/超声造影/经直肠超声/靶向穿刺活检

Key words

prostate cancer/superb microvascular imaging/contrast-enhanced ultrasound/transrectal ultrasound/targeted puncture biopsy

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基金项目

上海市浦东新区卫生健康委员会卫生计生科研项目(PW2021A-34)

出版年

2024
中华肿瘤防治杂志
中华预防医学会 山东省肿瘤防治研究院

中华肿瘤防治杂志

CSTPCD北大核心
影响因子：1.292
ISSN：1673-5269
参考文献量16
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