临床分期和磁共振成像(MRI)对前列腺癌分期的临床意义

目的：探讨临床分期和磁共振成像(MRI)分期预测前列腺癌病理分期的临床意义。方法：对32例局限性前列腺癌术前经直肠指诊进行临床分期及MRI分期预测前列腺癌根治术后的病理分期结果，评价诊断性实验结果。结果：直肠指诊临床分期和MRI分期预测前列腺癌的病理结果有显著相关性(P=0．002)。临床分期和MRI分期对局限于前列腺内肿瘤的预测(PPV)分别为63.3％和80．9％；对浸润包膜及包膜外肿瘤的预测(NPV)分别为50．0％和88．9％。MRI对前列腺癌病理分期的预测更具有特异性和较高的准确性，能更好的预测前列腺癌的病理结果(P=0．023)。结论：MRI较直肠指诊能更好地预测局限于前列腺内的肿瘤，对前列腺包膜及包膜以外浸润的肿瘤能进行更准确的分期。

The Evaluation of the Clinical and MRI Staging for Prostate Cancer before Radical Prostatectomy

Objective:To evaluate the clinical significance of clinical staging and MRI staging for prostate cancer before radical prostatectomy.Methods:Thirty-two patients of organ confined prostate cancer were reviewed to assess the accuracy of clinical staging and MRI staging to correlate with pathological staging results after radical prostatectomy.Results:33.3%(10/30)prostate cancer with staging C and3.3%(1/30)prostate cancer with staging D were diagnosed by pathology after radical prostatectomy in thirty patients of prostate cancer with clinical staging B,and36.7%(11/30)under staging;Only one patient over staging in clinical staging C.19.1%(4/21)prostate cancer with staging C were diagnosed in twenty-one patients of prostate cancer and under staging with MRI staging B;11.1%(1/9)over staging with MRI staging C.The clinical staging and MRI staging have more correlation with pathological staging results(P=0.002),and to predict the organ confined prostate cancer were63.3%,80.9%respectively,and the nonorgan confined prostate cancer were50%,88.9%respectively.MRI staging was more specificity and ac-curacy than that of clinical staging results to predict pathological staging results before radical prostatectomy (P=0.023).Conclusions:The MRI staging was more accuracy than that of clinical staging to predict pathological staging results in organ confined and nonorgan confined prostate cancer before radical prostatectomy .