TRUS引导下前列腺穿刺活检联合PSA水平变化在诊断前列腺癌中的价值

目的 探讨经直肠内超声(TRUS)引导下前列腺穿刺活检联合血清前列腺特异性抗原(PSA)诊断前列腺癌(PCA)的临床价值.方法 选取怀疑为PCA的患者128例,分别接受TRUS引导下前列腺穿刺活检、血清PSA检测,以最终病理学检查结果作为金标准,探讨二者联合诊断PCA的临床价值.结果 不同PSA水平下TRUS引导下前列腺穿刺活检对PCA的检出率比较,差异有统计学意义(P﹤0.001).血清PSA检测鉴别诊断PCA的灵敏度为72.97%,特异度为61.11%,漏诊率为27.03%,误诊率为38.89%;TRUS引导下前列腺穿刺活检鉴别诊断PCA的灵敏度为70.27%,特异度为61.11%,漏诊率为29.73%,误诊率为38.89%;TRUS引导下前列腺穿刺活检联合血清PSA检测鉴别诊断PCA的灵敏度为98.65%,特异度为87.04%,漏诊率为1.35%,误诊率为12.96%.结论 TRUS引导下前列腺穿刺活检联合血清PSA检测诊断PCA的临床价值高于二者单独应用.

The value of transrectal ultrasound guided prostate biopsy combined with PSA test in the diagnosis of PCA

Objective To investigate the clinical value of transrectal ultrasound guided prostate biopsy (TRUS) com-bined with serum prostate specific antigen (PSA) test in the diagnosis of prostate cancer (PCA). Method A total of 128 patients with suspected PCA were enrolled in the study. TRUS and PSA test were performed in these patients. The final pathological results was used as the gold standard. The clinical value of the combined detection of PCA was investigated. Result The detection rate of PCA using TRUS with various levels of PSA differed significantly (P<0.001). The sensitivi-ty of serum PSA in differential diagnosis of PCA patients was 72.97%, the specificity was 61.11%, the rate of missed diag-nosis rate was 27.03%, the misdiagnosis rate was 38.89%; as for TRUS, the sensitivity was 70.27%, specificity was 61.11%, rate of missed diagnosis was 29.73%, and the misdiagnosis rate was 38.89%;when TRUS and serum PSA test were combined, the sensitivity was 98.65%, specificity was 87.04%, rate of missed diagnosis was 1.35%, and the misdiag-nosis rate was 12.96%. Conclusion The clinical value of TRUS combined with serum PSA test is higher than each used separately.