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目的探讨经直肠超声(transrectal ultrasound,TRUS)引导下前列腺穿刺活检结合血清前列腺特异抗原(prostate specific antigen,PSA)在诊断前列腺癌(prostate cancer,PCA)中的临床意义。方法经直肠超声检查联合超声引导下穿刺病理证实的前列腺癌患者62例,病例来源于2005年1月至2014年8月在本院超声诊断科检查的3 874例前列腺疾病门诊患者,年龄(68.5±13.5)岁,分析前列腺癌经直肠超声图像特征分型及其PSA值的分布情况。结果前列腺癌的经直肠超声图像特征可分为隐匿型、结节型、弥漫浸润型及弥漫浸润伴结节型,且弥漫浸润型和弥漫浸润伴结节型各自与前两种(隐匿型和结节型)之间的PSA值差异有统计学意义(P<0.01),而隐匿型和结节型之间以及弥漫浸润型和弥漫浸润伴结节型组别之间的PSA值差异无统计学意义(P>0.05)。结论血清PSA值结合TRUS引导下前列腺穿刺活检,对于前列腺癌(尤其是隐匿性和弥漫浸润型前列腺癌)具有重要诊断价值。
Objective To investigate the clinical significance of prostate biopsy and serum prostate specific antigen (PSA) in the diagnosis of prostate cancer (PCA) guided by transrectal ultrasound (TRUS). Methods Totally 62 cases of prostate cancer were confirmed by transrectal ultrasonography combined with ultrasound guided biopsy. The cases were from 3874 cases of prostate disease outpatients who underwent ultrasonic diagnosis in our hospital from January 2005 to August 2014, with a mean age of 68.5 ± 13.5) years of age, analysis of transrectal ultrasound image features of prostate cancer and its distribution of PSA values. Results The characteristics of transrectal ultrasound images of prostate cancer can be divided into occult, nodular, diffuse infiltration and diffuse infiltration with nodular, and diffuse infiltration and diffuse infiltration with nodular and the former two (occult and (P <0.01). There was no statistical difference in PSA between occult and nodular types and between diffuse infiltrative and diffuse infiltrating nodular types Significance (P> 0.05). Conclusion The combination of serum PSA and TRUS-guided prostate biopsy has important diagnostic value for prostate cancer, especially for occult and diffuse infiltrating type of prostate cancer.