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目的探讨经直肠实时超声弹性成像(transrectal real-time tissue elastography,TRTE)在前列腺癌诊断及病理分级中的应用价值。方法选择2013年1月—2014年11月收治的86例疑似前列腺癌患者作为研究对象。于患者穿刺病理活检或手术治疗前行TRTE检查及经直肠超声(transrectal ultrasound,TRUS)检查,统计两种检查方案对前列腺癌的检出率及良恶性肿瘤鉴别能力,并与穿刺活检结果进行比较。计数资料采用χ2检验,P<0.05为差异有统计学意义。结果 TRTE诊断前列腺肿瘤准确度、良性诊断准确度、恶性诊断准确度分别为91.86%、90.48%、93.18%,TRUS分别为65.12%、57.14%、72.73%,差异均有统计学意义(均P<0.05)。TRTE诊断前列腺癌敏感度、特异度、阳性预测值、阴性预测值分别为91.11%、92.68%、93.18%、90.48%,TRUS分别为64.00%、66.67%、72.73%、57.14%,差异均有统计学意义(均P<0.05)。良性肿瘤弹性成像病灶分级Ⅰ~Ⅴ级患者数分别为25、14、2、1、0例,恶性分别为0、2、10、21、11例,两组差异有统计学意义(P<0.05)。结论 TRTE诊断前列腺肿瘤具有较高的准确度,并可初步评估病变的良恶性质,对前列腺癌的早期诊断具有重要的临床应用价值。
Objective To investigate the value of transrectal real-time tissue elastography (TRTE) in the diagnosis and pathological grade of prostate cancer. Methods Totally 86 patients with suspected prostate cancer admitted from January 2013 to November 2014 were enrolled in this study. TRTE and transrectal ultrasound (TRUS) were performed prior to biopsy or surgical biopsy. The detection rates of prostate cancer and benign and malignant tumors were compared between the two methods and compared with biopsy results . Count data using χ2 test, P <0.05 for the difference was statistically significant. Results The diagnostic accuracy of TRTE for prostate cancer was 91.86%, 90.48%, 93.18% respectively, and TRUS was 65.12%, 57.14%, 72.73% respectively (all P < 0.05). The sensitivity, specificity, positive predictive value and negative predictive value of TRTE in diagnosing prostate cancer were 91.11%, 92.68%, 93.18% and 90.48% respectively, and TRUS were 64.00%, 66.67%, 72.73% and 57.14% respectively Significance (both P <0.05). There were 25, 14, 2, 1 and 0 cases of benign tumor elastosis grade Ⅰ ~ Ⅴ, respectively, with malignant lesions of 0, 2, 10, 21 and 11 cases, respectively ). Conclusion TRTE has high accuracy in diagnosing prostate cancer, and can evaluate the benign and malignant features of the disease preliminarily. It has important clinical value in the early diagnosis of prostate cancer.