经直肠超声引导下前列腺穿刺活检联合血清前列腺特异抗原诊断老年前列腺癌的价值

发布时间：2018-04-05 15:09

本文选题：经直肠超声　切入点：前列腺　出处：《中国老年学杂志》2017年16期

【摘要】：目的探讨经直肠超声引导下前列腺穿刺活检联合血清前列腺特异抗原(PSA)检查对老年前列腺癌患者的诊断价值。方法选择行血清分类PSA筛查的前列腺病变老年患者398例,且均行经直肠超声引导下前列腺穿刺活检。比较各组分类PSA水平、PSA密度(PSAD)以及不同超声特征分型的前列腺癌患者分类PSA水平及PSAD。结果 398例患者经直肠超声引导下前列腺穿刺活检后,病理检查确诊为前列腺癌48例,前列腺炎33例,前列腺增生317例。前列腺癌组游离PSA(F-PSA)、总PSA(T-PSA)、PSAD均显著高于前列腺炎组和前列腺增生组,F/T-PSA显著低于前列腺炎组和前列腺增生组(P0.05),前列腺炎组F-PSA、T-PSA、PSAD显著高于前列腺增生组(P0.05),两组F/T-PSA比较无统计学差异(P0.05)。根据前列腺癌患者超声图像特征将患者分为隐匿型、结节型、弥漫浸润型、弥漫浸润结节型。弥漫浸润型、弥漫浸润结节型F-PSA、TPSA、PSAD均显著高于隐匿型和结节型(P0.05),弥漫浸润型与弥漫浸润结节型F-PSA、T-PSA、PSAD比较无统计学差异,隐匿型和结节型F-PSA、T-PSA、PSAD比较无统计学差异,各组F/T-PSA比较无统计学差异(均P0.05)。结论经直肠超声前列腺穿刺活检联合血清PSA有助于提高老年前列腺癌的诊断,但由于多种因素的影响可能存在假阳性和假阴性,应开展穿刺活检,及早诊断。
[Abstract]:Objective to evaluate the diagnostic value of transrectal ultrasound guided prostate biopsy combined with serum prostate specific antigen (PSAs) in elderly patients with prostate cancer.Methods 398 elderly patients with prostatic disease were selected for serum PSA screening, all of whom underwent transrectal ultrasound guided prostate biopsy.The PSA level and PSAD of prostate cancer patients with different ultrasonic characteristics were compared.Results after transrectal ultrasound guided prostate biopsy, 48 cases of prostate cancer, 33 cases of prostatitis and 317 cases of prostatic hyperplasia were diagnosed by pathological examination.The free PSA-PSAD and total PSAT-PSAD in prostate cancer group were significantly higher than those in prostatitis group and prostatic hyperplasia group (P < 0.05). The level of F-PSAT-PSAD in prostatitis group was significantly higher than that in prostatic hyperplasia group (P 0.05). There was no significant difference in F/T-PSA between the two groups.According to the ultrasonographic features of prostate cancer, the patients were classified into occult type, nodular type, diffuse infiltrative type and diffuse infiltrating nodular type.The PSAD of diffuse infiltrating type and diffuse infiltrating nodular type was significantly higher than that of occult type and nodular type (P0.05). There was no significant difference between diffuse infiltrating type and diffuse infiltrating nodular type F-PSAT-PSAD, but there was no significant difference between occult type and nodular type of F-PSA-T-PSAPSAD.There was no significant difference in F/T-PSA in each group (all P 0.05).Conclusion Transrectal ultrasound prostate biopsy combined with serum PSA is helpful to improve the diagnosis of prostate cancer in the elderly. However, due to the influence of many factors, false positive and false negative may exist, so it is necessary to carry out puncture biopsy to diagnose prostate cancer as early as possible.
【作者单位】：青海省人民医院超声科;
【分类号】：R445.1;R737.25

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