前列腺外周带彩色多普勒超声参数评估前列腺癌骨转移的应用价值
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摘要
目的探讨前列腺外周带彩色多普勒超声参数在评估前列腺癌骨转移中的应用价值。方法选择2015年1月至2018年6月内蒙古自治区人民医院经活组织检查确诊的前列腺癌患者132例,年龄53～87岁,平均年龄72.3岁。使用单光子计算机体层摄影术(SPECT)/CT全身骨骼成像作为判断患者是否有骨转移的标准,根据是否有骨转移,分为前列腺癌骨转移组和前列腺癌非骨转移组。绘制受试者工作特征曲线(ROC),计算曲线下面积,分析前列腺外周带彩色多普勒超声参数在评估前列腺癌骨转移中的作用。统计指标,即收缩期血流速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)、搏动指数(PI)、收缩期血流速度/舒张末期血流速度(S/D)。结果前列腺癌骨转移组51例(38.6%),前列腺癌非骨转移组81例(61.4%)。外周带彩色多普勒超声参数分析显示,骨转移组患者的PSV、RI、PI及S/D指标均高于非骨转移组,差异具有统计学意义(Z=4.426、7.633、9.534、8.328,P <0.05);ROC显示,参数RI、PI及S/D曲线下面积均高于0.85,评估骨转移的准确度分别为83.33%、85.60%及85.60%。结论前列腺外周带彩色多普勒超声参数RI、PI及S/D在评估前列腺癌骨转移中有较高参考价值,为前列腺癌骨转移的早期诊断提供帮助。
Objective To explore the application value of color Doppler ultrasound parameters of prostate peripheral zone in evaluating prostate cancer with bone metastasis. Methods From January 2015 to June 2018, 132 prostate cancer patients diagnosed by biopsy were enrolled, which aged 53-87 years old with mean age of 72.3 years old. The prostate cancer single photon emission computed tomography(SPECT)/CT whole body bone imaging confirmed as the standard for bone metastasis, all of the patients were divided into bone metastasis group and non-bone metastasis group. The receiver operating characteristic curve(ROC) was drawn, area under curve was calculated, and role of color Doppler ultrasound parameters in periphery of prostate in evaluation of prostate cancer with bone metastasis was analyzed. The statistical indicators included systolic blood flow velocity(PSV), end-diastolic blood flow velocity(EDV), resistance index(RI), pulsatility index(PI), systolic blood flow velocity/end-diastolic blood flow velocity(S/D). Results There were 51 cases(38.6 %) in prostate cancer bone metastasis group and81 cases(61.4 %) in non-bone metastasis group. The results of color Doppler ultrasound parameters in peripheral zone of prostate showed that PSV, RI, PI and S/D indexes in bone metastasis group were higher than those in non-bone metastasis group, and the difference was statistically significant(Z = 4.426, 7.633, 9.534, 8.328, P < 0.05); ROC curve showed that RI,PI and S/D area under curve were all bigger than 0.85, and accuracy of bone metastasis was 83.33 %, 85.60 % and 85.60 %,respectively. Conclusion It is demonstrated that the color Doppler ultrasound parameters of prostate peripheral zone RI, PI and S/D showed higher reference value in evaluation of prostate cancer with bone metastasis, which provides help for early diagnosis of prostate cancer with bone metastasis.
Objective To explore the application value of color Doppler ultrasound parameters of prostate peripheral zone in evaluating prostate cancer with bone metastasis. Methods From January 2015 to June 2018, 132 prostate cancer patients diagnosed by biopsy were enrolled, which aged 53-87 years old with mean age of 72.3 years old. The prostate cancer single photon emission computed tomography(SPECT)/CT whole body bone imaging confirmed as the standard for bone metastasis, all of the patients were divided into bone metastasis group and non-bone metastasis group. The receiver operating characteristic curve(ROC) was drawn, area under curve was calculated, and role of color Doppler ultrasound parameters in periphery of prostate in evaluation of prostate cancer with bone metastasis was analyzed. The statistical indicators included systolic blood flow velocity(PSV), end-diastolic blood flow velocity(EDV), resistance index(RI), pulsatility index(PI), systolic blood flow velocity/end-diastolic blood flow velocity(S/D). Results There were 51 cases(38.6 %) in prostate cancer bone metastasis group and81 cases(61.4 %) in non-bone metastasis group. The results of color Doppler ultrasound parameters in peripheral zone of prostate showed that PSV, RI, PI and S/D indexes in bone metastasis group were higher than those in non-bone metastasis group, and the difference was statistically significant(Z = 4.426, 7.633, 9.534, 8.328, P < 0.05); ROC curve showed that RI,PI and S/D area under curve were all bigger than 0.85, and accuracy of bone metastasis was 83.33 %, 85.60 % and 85.60 %,respectively. Conclusion It is demonstrated that the color Doppler ultrasound parameters of prostate peripheral zone RI, PI and S/D showed higher reference value in evaluation of prostate cancer with bone metastasis, which provides help for early diagnosis of prostate cancer with bone metastasis.
引文
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[10]LU Feng-ying,LIAO Xin-hong,LI Zhi-xian,et al.Application of microvascular density in determination of transrectal ultrasound hemodgynamics in differential diagnosis of prostate cancer and chronic prostatitis[J].Journal of Jilin U-niversity:Medicine Edition,2014,40(5):1104-1108.[卢凤迎,廖新红,李智贤,等.微血管密度在经直肠超声血流动力学检测鉴别诊断前列腺癌和慢性前列腺炎中的应用及其评价[J].吉林大学学报:医学版,2014,40(5):1104-1108.]
[11]QIAN Xiao-gang,YIN Li,GU Jia,et al.Clinical significance of hemodynamic parameters of prostatic capsular artery in prostate cancer screening[J].Chinese Journal of Ultrasonography,2013,22(3):270-271.[钱孝纲,殷理,顾佳,等.前列腺被膜支动脉血流动力学相关参数在前列腺癌筛查中的临床意义[J].中华超声影像学杂志,2013,22(3):270-271.]
[12]Chien TM,Lu YM,Geng JH,et al.Predictors of positive bone metastasis in newly diagnosed prostate cancer patients[J].Asian Pac J Cancer Prev,2016,17(3):1187-1191.
[13]Liu J,You P,Chen G,et al.Hyperactivated FRS2α-mediated signaling in prostate cancer cells promotes tumor angiogenesis and predicts poor clinical outcome of patients[J].Oncogene,2016,35(14):1750-1759.
[14]Sakamoto S,Ichikawa T.Mechanism of prostate cancer invasion and metastasis[J].Nihon Rinsho,2014,72(12):2086-2089.
[2]Nakajima K,Kho DH,Yanagawa T,et al.Galectin-3 cleavage alters bone remodeling:Different outcomes in breast and prostate cancer skeletal metastasis[J].Cancer Res,2016,76(6):1391-1402.
[3]WANG Ling,DONG Chang-yuan,HE Yi,et al.Hemodynamic study of transrectal color Doppler flow imaging in diagnosis of prostatic hypertrophy and prostatic cancer[J].Chinese Journal of Ultrasound in Medicine,2001,17(2):144-147.[王玲,董昌元,贺祎,等.经直肠彩色多普勒超声对前列腺增生和前列腺癌的血流动力学研究[J].中国超声医学杂志,2001,17(2):144-147.]
[4]WANG Xiao-yan,LING Bing,HUANG Xiang-hong,et al.The clinical stages and characteristic of transrectal ultrasonography for diagnosing prostate carcinoma[J].Chinese Journal of Ultrasound in Medicine,2014,30(2):150-154.[王小燕,凌冰,黄向红,等.前列腺癌经直肠超声表现及特征与临床分期探讨[J].中国超声医学杂志,2014,30(2):150-154.]
[5]Khanduri S,Katyal G,Goyal A,et al.Evaluation of prostatic lesions by transrectal ultrasound,color Doppler,and the histopathological correlation[J].Cureus,2017,9(7):e1422-e1422.
[6]Koo KC,Sang UP,Kim KH,et al.Predictors of survival in prostate cancer patients with bone metastasis and extremely high prostate-specific antigen levels[J].Prostate Int,2015,3(1):10-15.
[7]LIU Yan,XU Yong,LIU Ran-lu,et al.Diagnostic value of combining detection of PSA and PSAD in patients with prostate cancer bone metastasis[J].Shandong Medical Journal,2015,55(5):1-3,6-6.[刘妍,徐勇,刘冉录,等.血清PSA、PSAD检测在前列腺癌骨转移诊断中的价值[J].山东医药,2015,55(5):1-3,6-6.]
[8]SHEN Chao,LüKuan,GUO Hui-min,et al.The applied value of SPECT/CT fusion imaging in patients with bone metastasis[J].Journal of Medical Imaging,2014,24(9):1589-1592.[申超,吕宽,郭慧敏.探讨SPECT/CT图像融合对骨转移瘤的增益价值[J].医学影像学杂志,2014,24(9):1589-1592.]
[9]CHEN Ye-hui,NIE Pin,JIANG Wen,et al.Predictive factors for bone metastases of prostate cancer[J].Journal of Southern Medical University,2016,36(2):205-209.[陈业辉,聂品,江文,等.前列腺癌骨转移的预测因素[J].南方医科大学学报,2016,36(2):205-209.]
[10]LU Feng-ying,LIAO Xin-hong,LI Zhi-xian,et al.Application of microvascular density in determination of transrectal ultrasound hemodgynamics in differential diagnosis of prostate cancer and chronic prostatitis[J].Journal of Jilin U-niversity:Medicine Edition,2014,40(5):1104-1108.[卢凤迎,廖新红,李智贤,等.微血管密度在经直肠超声血流动力学检测鉴别诊断前列腺癌和慢性前列腺炎中的应用及其评价[J].吉林大学学报:医学版,2014,40(5):1104-1108.]
[11]QIAN Xiao-gang,YIN Li,GU Jia,et al.Clinical significance of hemodynamic parameters of prostatic capsular artery in prostate cancer screening[J].Chinese Journal of Ultrasonography,2013,22(3):270-271.[钱孝纲,殷理,顾佳,等.前列腺被膜支动脉血流动力学相关参数在前列腺癌筛查中的临床意义[J].中华超声影像学杂志,2013,22(3):270-271.]
[12]Chien TM,Lu YM,Geng JH,et al.Predictors of positive bone metastasis in newly diagnosed prostate cancer patients[J].Asian Pac J Cancer Prev,2016,17(3):1187-1191.
[13]Liu J,You P,Chen G,et al.Hyperactivated FRS2α-mediated signaling in prostate cancer cells promotes tumor angiogenesis and predicts poor clinical outcome of patients[J].Oncogene,2016,35(14):1750-1759.
[14]Sakamoto S,Ichikawa T.Mechanism of prostate cancer invasion and metastasis[J].Nihon Rinsho,2014,72(12):2086-2089.