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目的 探讨联合临床参数分期和磁共振成像 (MRI)分期预测前列腺癌病理分期的临床意义。 方法 对 5 3例经病理活检证实的局限性前列腺癌行根治性手术者术前经血清PSA(临界值16 .3ng/ml)加系统 6～ 8针穿刺后Gleason评分 (临界值 6分 )或穿刺阳性针数百分率 (临界值 34%～5 0 % )进行临床分期及MRI分期以预测术后病理分期 ,评价术前联合临床参数分期和MRI分期与病理分期的一致性。 结果 5 3例中 ,术前血清PSA加Gleason评分低于临界值 ,临床分期局限于前列腺内的肿瘤 (T2 ) 2 0例 ,术后有 2 5 .0 % (5 / 2 0 )为T3 ;术前血清PSA加穿刺阳性针数百分率低于临界值 ,临床分期为T2 2 0例 ,术后 30 % (6 / 2 0 )为T3 。术前临床参数分期为T3 者术后分别有 30 .3% (10 / 33)和30 .3% (10 / 33)为T2 。MRI诊断的 4 8例前列腺癌者中 ,术前分期局限于前列腺内的肿瘤 (T2 ) ,术后病理分期 4 2 .4 % (14 / 31)为T3 ,其中 1例为T2 N1;术前MRI分期为T3 者 ,术后 11.8% (2 / 17)为T2 ,5 .9%(1/ 17)术后为T3cN1。联合临床参数分期和MRI分期预测前列腺癌的病理结果有显著相关性 (r =0 .4 4 9,P =0 .0 0 1) ,且能预测病理结果 (χ2 =10 .739,P =0 .0 0 1) ,3种分期方法之间对前列腺癌病理结果的预测差异无统计学意义 (χ
Objective To investigate the clinical significance of clinical staging and magnetic resonance imaging (MRI) staging in predicting the pathological stage of prostate cancer. Methods The Gleason score (6 points) and the Gleason score (6 points) after the preoperative PSA (16.3ng / ml) and the system 6-8 puncture of 53 cases of localized prostate cancer confirmed by pathology biopsy, The number of puncturing positive stitches (critical value 34% ~ 50%) was used for clinical staging and MRI staging to predict postoperative pathological staging, and to evaluate the consistency of preoperative joint clinical parameters, MRI staging and pathological staging. Results Among 53 cases, preoperative serum PSA plus Gleason score was lower than the critical value. The clinical stage was limited to 20 cases of intrathoracic tumor (T2), and 25.0% (5/20) of postoperative T3 was T3. The percentage of preoperative serum PSA plus puncture-positive needle was less than the critical value, with a clinical stage of T220 and a postoperative 30% (6/20) T3. Preoperative clinical parameters of T3 were postoperative were 30.3% (10/33) and 30.3% (10/33) of T2. Of the 48 patients with prostate cancer diagnosed by MRI, the preoperative staging was confined to the tumor in the prostate (T2). The postoperative pathological stage was 42.2% (14/31) of T3, of which 1 was T2 N1. The MRI stage was T3, with 11.8% (2/17) of postoperative T2, and 5.9% (1/17) of postoperative T3cN1. There was a significant correlation between the clinical stage and MRI staging in predicting the pathological results of prostate cancer (χ2 = 10.739, P = 0, P0.01) .0 0 1). There was no significant difference between the three staging methods in predicting the pathological results of prostate cancer (χ