首页|经直肠超声测量膀胱内前列腺突出程度对临床有意义前列腺癌检出率的价值

经直肠超声测量膀胱内前列腺突出程度对临床有意义前列腺癌检出率的价值

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目的:探讨经直肠超声(TRUS)测量膀胱内前列腺突出程度(IPP)对临床有意义前列腺癌(CsPCa)检出率的价值.方法:回顾性分析2019 年1 月至2022 年12 月在东部战区总医院和江苏省人民医院经TRUS引导下行前列腺穿刺活检的患者128 例.TRUS测量IPP大小并进行分级(0~3 级),比较Gleason评分<7 分(对照组)和Gleason评分≥7 分(CsPCa组)患者临床病理及超声影像特征的差异及相关性.使用多元Logistic回归分析筛选与CsPCa检出率相关的因素.结果:单因素分析结果显示CsPCa组患者前列腺体积显著大于对照组[(51.3±12.1)ml vs(43.2±11.3)ml,P<0.05],PSAD显著低于对照组[(0.45±1.92)ng/ml vs(0.59±2.14)ng/ml,P<0.05].CsPCa在IPP 3级的患者中占比低于IPP 0~2级(56.0%vs 85.4%、87.1%、80.6%),差异具有统计学意义(P<0.05).Spearman相关分析结果表明,Gleason评分与前列腺体积呈正相关(r=0.612),与PSAD(r=-0.735)以及IPP分级(r=-0.619)呈负相关(P<0.05).通过 Logistic回归分析结果显示 IPP 3 级(OR 0.690,95%CI 0.380~0.995,P=0.032)为CsPCa的独立保护因素.结论:CsPCa与前列腺IPP分级具有显著相关性,与IPP0~2 级患者相比,IPP 3级患者经TRUS引导下穿刺活检CsPCa检出率降低.因此,IPP分级增高时需警惕假阴性率的发生.
Transrectal ultrasonography of intravesical prostatic protrusion and the detection rate of clinically significant prostate cancer
Objective:To investigate the value of transrectal ultrasonography(TRUS)in the detection of clinically significant prostate cancer(CsPCa)in patients with intravesical prostatic protrusion(IPP).Methods:We retrospectively analyzed the data on 128 patients undergoing TRUS-guided prostate biopsy in the General Hospital of Eastern Theater Command and Jiangsu Province Hospi-tal from January 2019 to December 2022.We measured the size of and graded IPP,compared the clinicopathological and ultrasono-graphic features of the patients in the CsPCa group(Gleason score≥7)and those in the control group(Gleason score<7),and ana-lyzed the correlation of the IPP grades with the detection rate of CsPCa by multivariate logistic regression analysis.Results:The prostate volume was significantly higher in the CsPCa group than in the control([51.3±12.1]vs[43.5±11.3]ml,P<0.05),whilethe PSAdensity(PSAD)remarkablylowerin the former than in the latter([0.45±1.92]vs[0.59±2.14]ng/ml,P<0.05)and so was the detection rate of CsPCa in the patients with IPP grade3 than in those with IPP grades0,1 and2(56.0%vs 85.4%,87.1%and 80.6%,P<0.05).Spearman correlation analysis showed that the Gleason score was correlated positively with the prostate volume(r=0.612)but negatively with PSAD(r=-0.735)and the IPP grade(r=-0.619)(P<0.05).Logis-tic regression analysis indicated that IPP grade3(OR:0.690,95%CI:0.380-0.995,P=0.032)was an independent protective factor for CsPCa.Conclusion:CsPCa is significantly correlated with the IPP grade,and the detection rate of CsPCa by TRUS-guided biopsy is lower in patients with IPP grade 3 than in those with IPP grades 0-2.Therefore,special attention should be paid to false negative probability in case of high-grade IPP.

prostate cancertransrectal ultrasonographyintravesical prostatic protrusionclinically significant prostate cancer

戴云、谢迎东、徐超丽、杨斌

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东部战区总医院超声诊断科,江苏 南京 210002

南京医科大学第一附属医院超声科,江苏 南京 210009

前列腺癌 经直肠超声 膀胱内前列腺突出程度 临床意义前列腺癌

2024

中华男科学杂志
南京军区南京总医院

中华男科学杂志

CSTPCD
影响因子:1.052
ISSN:1009-3591
年,卷(期):2024.30(4)
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