老年前列腺癌超声造影参数及不同分化程度与组织血管密度的关系

发布时间：2018-03-29 00:04

本文选题：经直肠超声造影　切入点：前列腺肿瘤　出处：《中国老年学杂志》2017年20期

【摘要】：目的探讨老年前列腺癌经直肠超声造影参数及分化程度与微血管密度的相关性。方法前瞻性选取62例血清前列腺特异性抗原升高,临床疑诊为恶性肿瘤的老年患者,行经直肠超声造影和穿刺活检。采用时间-强度曲线分析造影图像,记录6个造影参数:峰值强度、上升支斜率、下降支斜率、达峰时间、到达时间、曲线下面积。对穿刺活检获取的组织行CD34、VEGF抗体免疫组化检测和微血管密度计数,根据结果分为前列腺癌组、前列腺增生组;进一步依据gleason评分系统对前列腺癌组的腺体分化程度进行分级。比较各组造影参数及微血管密度,并进行相关性分析。结果前列腺癌组血清前列腺特异性抗原明显高于前列腺增生组(P0.05)。前列腺癌组超声造影曲线以速升速降型为主,而前列腺增生组以缓升缓降型为主;前列腺癌组峰值强度、上升支斜率明显大于前列腺增生组(P0.05);达峰时间、到达时间明显小于前列腺增生组(P0.05);两组下降支斜率、曲线下面积之间差异无统计学意义(P0.05)。前列腺组微血管密度明显高于前列腺增生组,差异有统计学意义(P0.05);前列腺癌组高分化、中分化、低分化患者的前列腺组微血管密度两两比较差异均有统计学意义(P0.05),分化程度越低,微血管密度计数越高。相关性分析显示,峰值强度、上升支斜率与微血管密度计数呈正相关;达峰时间、到达时间与微血管密度计数呈负相关;下降支斜率、曲线下面积无明显相关性。结论经直肠超声造影参数与组织微血管密度具有相关性,组织微血管密度随病灶分化程度的不同而不同,超声造影可推断前列腺病变微血管生成情况,有助于在早期无创评价病变性质及预后。
[Abstract]:Objective to investigate the correlation between transrectal ultrasound parameters and microvessel density (MVD) in elderly patients with prostate cancer. Methods 62 elderly patients with elevated serum prostate specific antigen and suspected malignant tumor were prospectively selected. Transrectal echocardiography and biopsy were performed. The time-intensity curve was used to analyze the imaging images. Six parameters were recorded: peak intensity, ascending slope, descending slope, peak time, arrival time, and so on. The area under the curve. CD34 VEGF antibody and microvessel density were detected by immunohistochemistry and divided into prostate cancer group and prostatic hyperplasia group according to the results. The degree of gland differentiation in prostate cancer group was further graded according to the gleason scoring system. The angiographic parameters and microvessel density were compared in each group. Results the serum prostate specific antigen in prostate cancer group was significantly higher than that in prostatic hyperplasia group (P 0.05). The peak intensity and ascending branch slope of prostate cancer group were significantly higher than that of prostatic hyperplasia group (P 0.05), the peak time and arrival time were significantly lower than that of prostatic hyperplasia group (P 0.05), and the slope of descending branch in both groups was lower than that in prostatic hyperplasia group. The microvessel density of prostate group was significantly higher than that of prostatic hyperplasia group (P 0.05), and the difference was statistically significant (P 0.05). There were significant differences in microvessel density between two groups of patients with low differentiation (P 0.05). The lower the differentiation degree, the higher the microvessel density count. Correlation analysis showed that the peak intensity, the slope of ascending branch and the count of microvessel density were positively correlated. The peak time and arrival time were negatively correlated with the microvessel density count, and there was no significant correlation between the slope of the descending branch and the area under the curve. Conclusion there is a correlation between the parameters of transrectal contrast-enhanced angiography and tissue microvessel density. Tissue microvessel density varies with the degree of lesion differentiation. Contrast-enhanced ultrasound can infer the formation of microvessel in prostate disease, which is helpful to evaluate the nature and prognosis of the lesion in early stage.
【作者单位】：潍坊市益都中心医院超声科;
【基金】：山东省自然科学基金(No.ZR2016HL022)
【分类号】：R445.1;R737.25

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