PSA、DRE结合MRI在前列腺穿刺活检中的应用研究

发布时间：2018-07-10 10:39

本文选题：PSA + MRI　；参考：《山东大学》2017年硕士论文

【摘要】：目的:通过分析血清PSA、DRE、MRI检查与前列腺穿刺阳性率之间的关系,探究PSA、DRE、MRI等检查对前列腺穿刺的指导意义,为临床工作提供参考。方法:回顾性的分析了我院2012年1月至2015年12月期间行B超引导下经直肠前列腺穿刺活检的770例患者的临床资料。根据PSA的值将患者分为4ng/ml,4-10ng/ml,10-20ng/ml,20ng/ml 四组,分析各 PSA 水平组中 MRI 及 DRE 检查结果与其穿刺阳性率之间的关系。采用SPSS statistics 20统计软件进行数据的统计分析。结果:随着PSA值的升高,前列腺穿刺的阳性率也逐渐升高,前列腺MRI及DRE检查结果阳的患者的穿刺阳性率高于检查结果阴性者(p0.01)。PSA4ng/ml时,MRI或DRE结果阳性时穿刺阳性率分别为19.3%、28.6%,与总体穿刺阳性率差别不大(p=0.79,p=0.15),MRI及DRE检查结果均阳性时穿刺阳性率为50.0%,高于MRI阳性时的穿刺阳性率(p=0.03);PSA介于4-10ng/ml时,MRI或DRE结果阳性时穿刺阳性率分别为38.1%、34.7%,高于总体穿刺阳性率(p0.01,p=0.02);MRI及DRE检查结果均阳性时穿刺阳性率为56.8%,高于MRI或DRE阳性时的穿刺阳性率(p0.01;p=0.03)。PSA介于10-20ng/ml时,MRI或DRE结果阳性时穿刺阳性率分别为37.1%、43.5%,高于总体穿刺阳性率(p=0.01,p0.01);MRI及DRE检查结果均阳性时穿刺阳性率为48.7%,与MRI或DRE检查结果阳性时的穿刺阳性率无统计学差异(p=0.14;p=0.62)。PSA20ng/ml时,MRI或DRE结果阳性时穿刺阳性率为80.4%、82.9%,高于总体穿刺阳性率(p0.01,p0.01);MRI及DRE检查结果均阳性时穿刺阳性率为90.3%,高于MRI检查结果阳性时的穿刺阳性率(p=0.01),与DRE检查结果阳性时穿刺阳性率差别不大(p=0.056)。结论:PSA4ng/ml时,单纯依靠MRI或DRE检查不能有效提高穿刺阳性率。PSA介于4-10ng/ml时,MRI及DRE检查均可提高穿刺阳性率,MRI或DRE检查结果阳性的患者应做进一步的DRE或MRI检查。PSA在10-20ng/ml时MRI及DRE检查均可提高穿刺阳性率。MRI检查结果阴性时应进一步的DRE检查。PSA20ng/ml时,总体穿刺阳性率较高,MRI及DRE检查均可提高穿刺阳性率。MRI检查结果阳性时应进一步做DRE检查;DRE检查结果阴性时应加做MRI检查。
[Abstract]:Objective: to analyze the relationship between serum PSA-DREE MRI and the positive rate of prostate puncture, to explore the guiding significance of PSA-DREE MRI for prostate puncture, and to provide reference for clinical work. Methods: the clinical data of 770 patients with transrectal prostate biopsy guided by B-ultrasound from January 2012 to December 2015 were analyzed retrospectively. Patients were divided into 4 ng / ml / ml 4-10 ng / ml 10 ~ (-20) ng / ml / ml group according to PSA value. The relationship between MRI and DRE examination results and puncture positive rate was analyzed in each PSA level group. The data were analyzed by SPSS statistics 20 software. Results: with the increase of PSA, the positive rate of prostate puncture increased gradually. The positive rate of puncture in patients with positive results of MRI and Dre examination was higher than that of patients with negative results (p0.01) .PSA4ng / ml. The positive rates of MRI or DRE were 19.3ng / ml or 28.6.The positive rates of MRI and DRE were not different from the total positive rate of puncture (p0.79% / 0.15). The positive rate of puncturing was higher than that of 4-10ng/ml (p0.03). The positive rate of puncture was 38.1% and 38.7% respectively when 4-10ng/ml or Dre were positive. The positive rate of puncture was 56.8% when the positive rate of MRI and DRE was higher than that of the total positive rate (p0.01p0.02) and the positive rate of DRE was 56.8%. The positive rate of puncture (p0.01p0.03). PSA was 37.1% or 43.5 when 10-20ng/ml or DRE was positive, which was higher than the total puncture positive rate (p0.01 / p0.01). The positive rate of puncture was 48.7% when MRI and DRE were both positive, and the positive rate was 48.7% with the results of MRI or DRE. There was no statistical difference in the positive rate of puncture (p0. 14 / p0. 62). The positive rate of MRI or Dre in PSA20 ng / ml was 80.4% and 82.9%, which was higher than that of the total puncture positive rate (p0.01 / p0.01). The positive rate of puncture was 90.3% when the results of MRI and Dre were positive, and it was higher than that of the positive results of MRI. The positive rate of puncture (p0. 01) was not different from that of Dre (p0. 056). When we conclude that when the size of the PSA4ng / ml, 4-10ng/ml or Dre can not improve the positive rate of puncture. Both MRI and Dre can improve the positive rate of puncture. The patients with positive results of MRIs or Dre should do further DRE or MRI.PSA in 10-20ng/ml and DRE examination. Examination can increase the positive rate of puncture. When the result of MRI is negative, Dre should be further examined. PSA20ngr / ml, The overall positive rate of puncture is higher. Both MRI and DRE can increase the positive rate of puncture. When the results of MRI are positive, we should further do DRE examination and do MRI when the results of DRE are negative.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.25

【相似文献】