目的 探讨经直肠实时组织弹性成像(transrectal real-time tissue elastography,TRTE)引导靶向穿刺诊断前列腺癌的临床应用价值.方法 选取 2020 年 1 月至 2022 年 12 月于郑州市第一人民医院就诊的可疑前列腺癌患者 52 例为研究对象,术前均行经直肠常规超声及TRTE检查评估前列腺病变的良恶性,对TRTE发现可疑病灶的 28 例患者行TRTE引导靶向穿刺(2 针)+系统穿刺(8 针),对TRTE未发现可疑病灶的 24 例患者行直肠常规超声引导系统穿刺(12 针),分析TRTE诊断前列腺癌的效能及对比分析靶向穿刺与系统穿刺的穿刺阳性率.结果 本研究最终病理确诊前列腺癌 25例,良性病变 27 例;TRTE诊断前列腺癌 28 例,良性病变 24 例,诊断的阳性预测值、阴性预测值分别为 75.0%(21/28)、83.3%(20/24).TRTE发现可疑病灶的 28 例患者,靶向穿刺共 56 针,诊断前列腺癌 36 针,阳性率 64.29%(36/56),系统穿刺共 224 针,诊断前列腺癌 89 针,阳性率 39.73%(89/224);靶向穿刺的前列腺癌穿刺阳性率显著高于系统穿刺(P<0.05).结论 TRTE 可较好地诊断前列腺癌,其引导靶向穿刺诊断前列腺癌的阳性率更高,可在减少穿刺针数的基础上最大限度提高穿刺阳性率.
Objective To investigate the clinical application value of transrectal real-time tissue elastography(TRTE)guided targeted puncture in the diagnosis of prostate cancer.Methods A total of 52 patients with suspected prostate cancer who were treated in the First People's Hospital of Zhengzhou from January 2020 to December 2022 were selected as the study objects.Preoperative routine transrectal ultrasound and TRTE examination were performed to evaluate the benign and malignant prostates.For the 28 patients with suspected lesions found in TRTE,TRTE-guided targeted puncture(2 needles)+ systematic puncture(8 needles)were performed,for the 24 patients with no suspicious lesions found in TRTE,routine ultrasound-guided systematic puncture(12 needles)was performed.The efficacy of TRTE in the diagnosis of prostate cancer was analyzed and the positive rate of targeted puncture and systematic puncture was compared.Results In this study,25 cases of prostate cancer and 27 cases of benign lesions were ultimately pathologically diagnosed,while a total of 28 cases of prostate cancer and 24 cases of benign lesions were diagnosed with TRTE.The positive predictive value and negative predictive value of the diagnosis were 75.0%(21/28)and 83.3%(20/24),respectively.In 28 patients with suspected lesions found by TRTE,a total of 56 needles were targeted puncture,36 needles were diagnosed with prostate cancer,positive rate was 64.29%(36/56),and a total of 224 needles were systematic puncture,89 needles were diagnosed with prostate cancer,with a positive rate of 39.73%(89/224).The positive rate of prostate cancer by targeted puncture was significantly higher than that by systematic puncture(P<0.05).Conclusion TRTE can better diagnose prostate cancer,and its guided targeted puncture has a higher positive rate in the diagnosis of prostate cancer,which can maximize the positive rate of puncture while reducing the number of puncture needles.
冯战启;胡和平;刘彦军;李纪华;吴辉
郑州市第一人民医院泌尿外科,河南郑州 450004
临床医学
经直肠实时组织弹性成像;靶向穿刺;前列腺癌;穿刺阳性率
Transrectal real-time tissue elastography;Targeted puncture;Prostate cancer;Puncture positivity rate
《中国现代医生》 2024 (001)
15-17,51 / 4
河南省医学科技攻关计划联合共建项目(LHGJ20200695)
10.3969/j.issn.1673-9701.2024.01.004
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