经直肠实时组织弹性成像联合峰值应变指数靶向穿刺活检诊断外周带前列腺癌的价值

目的 探讨经直肠实时组织弹性成像（TRTE）联合峰值应变指数（PSI）靶向穿刺活检诊断外周带前列腺癌的应用价值。方法 选取于我院就诊的127例疑似外周带前列腺癌患者，均行经直肠超声（TRUS）和TRTE检查，计算PSI；然后行TRUS系统穿刺活检、TRTE联合PSI靶向穿刺活检，根据手术病理结果分为前列腺癌组92例和良性病变组35例，比较两组PSI和各临床资料的差异；比较TRUS系统穿刺活检与TRTE联合PSI靶向穿刺活检对外周带前列腺癌的检出率及穿刺点阳性率；绘制受试者工作特征（ROC）曲线分析TRTE联合PSI靶向穿刺活检对外周带前列腺癌的诊断效能。结果 前列腺癌组PSI、血清前列腺特异性抗原（PSA）均高于良性病变组，差异均有统计学意义（均P<0.001）。92例外周带前列腺癌患者中，TRTE联合PSI靶向穿刺活检诊断85例，TRUS系统穿刺活检诊断78例，二者对外周带前列腺癌的检出率比较（66.9%vs. 61.4%），差异无统计学意义。127例患者共穿刺1524针，其中TRUS系统穿刺1270针，TRTE联合PSI靶向穿刺254针，二者穿刺点阳性率比较（17.9%vs....

The application value of transrectal real-time tissue elastography combined with peak strain index targeted biopsy in the diagnosis of peripheral zone prostate cancer

Objective To evaluate the value of transrectal real time tissue elastography combined with peak strain index targeting needle biopsy in the diagnosis of peripheral zone prostate cancer.Methods A total of 127 patients with suspected peripheral prostate cancer were selected. All patients underwent transrectal ultrasound (TRUS) and transrectal real-time tissue elastography (TRTE) examination, and the peak strain index (PSI) was calculated based on the pathological results.The diagnostic results of TRUS system biopsy and TRTE combined with PSI-targeted biopsy in peripheral zone prostate (PCa) were compared, and ROC curve was drawn to analyze the diagnostic efficacy of TRTE combined with PSI-targeted biopsy in peripheral zone prostate (PCa).Results 92 PCa patients were detected with PSI averaging 26.91±14.66.The mean PSI was 7.49±6.35 in 35 benign lesions of prostate, and the difference was statistically significant (t=4.491, P < 0.001).The sensitivity and specificity of TRTE combined with PSI targeted biopsy in the diagnosis of PCa were 92.39% and 88.57%, both of which were higher than that of TRUS combined with systematic puncture biopsy.ROC curve analysis showed that the area under curve (AUC) of PCa diagnosed by TRTE combined with PSI-targeted biopsy was 0.923 with a cut-off value of 9.72 PSI [95% confidence interval: 0.879- 0.967], and when PSA>20 ng/ mL, the sensitivity and specificity of TRTE combined with PSI targeted biopsy for the diagnosis of peripheral zone PCa were 96.08% and 91.82%, respectively.Conclusion Real-time transrectal tissue elastography combined with peak strain index targeting biopsy of peripheral prostate cancer has good clinical application value.