目的：声触诊组织定量技术（VTTQ）是一种检测组织硬度的新技术。本研究的目的是比较VTTQ和直肠指诊（DRE）之间对于前列腺癌（PCa）和良性前列腺增生（BPH）的效能。方法：VTTQ用于检测60例BPH和疑似PCa患者，每一个病灶通过声辐射脉冲（ARFI）激发并测量相应病变的剪切波速（SWV）值。测值与病理结果对照，对VTTQ和DRE鉴别PCa和BPH之间的诊断效能进行比较。结果：PCa和BPH组织的SWV值（m?蛐s）明显大于正常前列腺组织（2.97±0.42，2.61±0.47，2.46±0.52），差异有显著性。在ROC曲线中，以SWV>2.87 m?蛐s为诊断标准，VTTQ诊断前列腺良恶性病变的曲线下面积（AUC）为0.78，而DRE是0.67。VTTQ诊断PCa的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为80.0%，66.7%，74.3%，72.0%，79.2%，而DRE分别为57.5%，52.3%，62.5%，57.0%，62.1%。结论：VTTQ可以有效地检测前列腺结节病变的硬度，在鉴别PCa和BPH方面比DRE具有更高的诊断效能。
Abstract
Objective: Virtual touch tissue quantification(VTTQ) is a new, promising technique for detecting the stiffness of tissues. The aim of this study is to compare the performance of VTTQ and digital rectal examination(DRE) in discrimination between prostate cancer(PCa) and benign prostatic hyperplasia(BPH). Methods: VTTQ was performed in 60 patients with suspected BPH and PCa before the prostate histopathologic examination. The shear wave velocity(SWV) at each nodular lesion was quantified by implementing an acoustic radiation force impulse(ARFI). The performance of VTTQ and DRE in discrimination between PCa and BPH was compared by the pathology. Results: The SWV values(m/s) were significantly greater in PCa and BPH than in normal prostate(2.97±0.42, 2.61±0.47 and 2.46±0.52). The area under the receiver operating characteristic curve(AUC) for VTTQ(SWV>2.87 m/s) to differentiate prostate nodules as benign hyperplasia or malignancy was 0.78, while it was 0.67 for DRE. The diagnostic sensitivity, specificity, PPV, NPV and accuracy were 80.0%, 66.7%, 74.3%, 72.0%, 79.2%, respectively for VTTQ(SWV>2.87 m/s), whereas they were 57.5%, 52.3%, 62.5%, 57.0%, 62.1% respectively for DRE. Conclusion: VTTQ can effectively detect the stiffness of prostate nodular lesions, which has a significantly higher performance than DRE in discrimination between PCa and BPH.
关键词
前列腺肿瘤 /
前列腺增生 /
超声检查 /
多普勒 /
彩色
Key words
Prostatic neoplasms /
Prostatic hyperplasia /
Ultrasonography, Doppler, color
中图分类号：
Ｒ737.25
Ｒ697.3
Ｒ445.1
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1]Milecki P, Martenka P, Antczak A, et al. Radiotherapy combined with hormonal therapy in prostate cancer: the state of the art[J]. Cancer Manag Res, 2010, 2(11): 243-253.
[2]Wolf AM, Wender RC, Etzioni RB, et al. American Cancer Society Guideline for the Early Detection of Prostate Cancer: Update 2010[J]. CA Cancer J Clin, 2010, 60(12): 70-98.
[3]Wang N, Gerling GJ, Childress RM, et al. Quantifying palpation techniques in relation to performance in a clinical prostate exam[J]. IEEE Trans Inf Technol Biomed, 2010, 14(7): 1088-1097.
[4]Hodolic M. Role of F-18-choline PET/CT in evaluation of patients with prostate carcinoma[J]. Radiol Oncol, 2011, 45(2): 17-21.
[5]Gallotti A, D’Onofrio M, Pozzi Mucelli R. Acoustic Radiation Force Impulse(ARFI) technique in ultrasound with virtual touch tissue quantification of the upper abdomen[J]. Radiol Med, 2010, 115(8): 889-897.
[6]Osaki A, Kubota T, Suda T, et al. Shear wave velocity is a useful marker for managing nonalcoholic steatohepatitis[J]. World J Gastroenterol, 2010, 16(9): 2918-2925.
[7]龚继军，孙德胜，钟洁愉，等． 声辐射力脉冲成像技术在乳腺占位性病灶中的研究[J]． 临床超声医学杂志，2013，15（1）：29-38.
[8]Miyanaga N, Akaza H, Yamakawa M, et al. Tissue elasticity imaging for diagnosis of prostate cancer: a preliminary report[J]. Int J Urol, 2006, 13(4): 1514-1518.
[9]Miyagawa T, Tsutsumi M, Matsumura T, et al. Real-time elastography for the diagnosis of prostate cancer: Evaluation of elastographic moving images[J]. Jpn J Clin Oncol, 2011, 39(5): 394-398.
[10]D’Onofrio M, Gallotti A, Martone E, et al. Solid appearance of pancreatic serous cystadenoma diagnosed as cystic at ultrasound acoustic radiation force impulse imaging[J]. JOP, 2009, 10(7): 543-546.
[11]Nightingale K, Soo MS, Nightingale R, et al. Acoustic radiation force impulse imaging: in vivo demonstration of clinical feasibility[J]. Ultrasound Med Biol, 2002, 28(12): 227-235.
[12]Krouskop TA, Wheeler TM, Kallel F, et al. Elastic moduli of breast and prostate tissues under compression[J]. Ultrason Imaging, 1998, 20(11): 260-274.
基金
本课题受深圳市科技计划项目资助（项目编号：JCYJ20140415162338776）。
