前列腺特异抗原和经直肠超声引导前列腺穿刺活检对前列腺癌的诊断价值

目的 探讨前列腺声像图特点、血清前列腺特异抗原(PSA)水平在前列腺癌诊断中的价值.方法 分析47例经直肠超声引导系统6点加目的 性穿刺患者前列腺声像图特点及临床资料,其中前列腺癌组17例,前列腺增生组30例.结果 前列腺癌组与前列腺增生组异常血流信号发现率分别为88.2%、36.7%,差异有统计学意义(P <0.05);两组异常回声结节发生率和前列腺体积的差异无统计学意义(P >0.05).游离前列腺特导性抗原(FPSA )、前列腺特导性抗原密度(PSAD)、FPSA/总前列腺特异抗原(TPSA)对前列腺癌诊断的ROC曲线面积分别为0.692、0.739、0.214.以PSAD≥0.15 μg/ml·cm3诊断前列腺癌的阳性预测值为50%,敏感性为76.5%,特异性为56.7%.结论 异常血流分布较低回声结节更具有特征性的前列腺癌超声表现,其指导目的 性穿刺的准确率较高,PSAD是较TPSA及FPSA/TPSA更有价值的前列腺癌预测指标.

Value of prostate specific antigen and transrectal ultrasound-guided prostate biopsy in diagnosis of prostate cancer

Objective To explore the value of prostate ultrasonographic characteristics and serum prostate specific antigen(PSA) level in diagnosis of prostate cancer.Methods The clinical data and ultrasonographic characteristics of 47 patients with transrectal ultrasound-guided prostate biopsy 6-core and puncture in purpose were analyzed,including 17 cases of prostate cancer and 30 cases of prostatic hyperplasia.Results The detection rate of abnormal flow signals in prostate cancer and prostatic hyperplasia group were 88.2% and 36.7%,respectively.There was significant difference between the two groups(P <0.05).There were no significant difference in the incidence of prostate nodules and prostate volumn between the two groups.The areas under ROC curves of FPSA,PSAD,FPSA/TPSA in diagnosis of prostate cancer were 0.692,0.739 and 0.214,respectively.When PSAD was more or equal to 0.15 μg/ml·cm3,the postive predictive value,sensitivity and specificity of protate cancer diagnosis were 50%,76.5% and 56.7%,respectively.Conclusion Abnormal blood flow distribution was more characteristic ultrasonographic features than low echo nodules in forecasting protate cancer,and it can guide puncture with higher accuracy.Prostate volume corrected PSAD is more valuable than TPSA and FPSA/TPSA in forecasting prostate cancer.