【摘要】 目的:探讨无创方法直肠指检(direct rectal examination,DRE),经肛门直肠超声波检查(transrectal ultrasonography,TRUS),核磁共振检查(megnatic resonance imaging,MRI)诊断灰区前列腺癌的意义及可行性。方法:选择灰区前列腺癌34例和前列腺增生病例41例;分别行DRE、TRUS、MRI检查,计算各自的诊断符合率和漏诊率并比较。结果:DRE对灰区前列腺癌的诊断符合率61.8%,漏诊率38.2%,假阳性率7.3%;TRUS对灰区的诊断符合率70.6%,漏诊率29.4%,假阳性率14.6%;MRI对灰区的诊断符合率47.1%,漏诊率52.9%,假阳性率19.5%。联合DRE和穿刺活检,诊断符合率为79.4%;联合TRUS和穿刺活检,诊断符合率为91.2%;联合MRI和穿刺活检,诊断符合率为76.5%。结论:3种无创方法中TRUS有较好的检测效能,联合穿刺活检可明显减少灰区前列腺癌的漏诊率。更多还原

【Abstract】 Objective:To investigate the value and feasibility of noninvasive diagnosis methods direct rectal examination(DRE),transrectal ultrasonography(TRUS) and megnatic resonance imaging(MRI) for prostate cancer(PCA) with prostate specific antigen(PSA) in gray zone.Methods:The data of 34 patients with PCA and 41 patients with benign prostate hyperplasia(BPH) were collected.All of them were diagnosed with PSA in gray zone.Every patient was examined by TRUS,DRE and MRI before operation.The correct rate of diagnosis and the missed diagnosis rate of TRUS,DRE and MRI were calculated and compared among the three methods.Results:The coincidence rate,the missed diagnosis rate and the false positive rate of PCA in grey zone were 61.8%,38.2% and 7.3% for DRE,70.6%,29.4% and 14.6% for TRUS,47.1%,52.9% and 19.5% for MRI respectively.The diagnostic coincidence rate was 79.4% for biopsy combined DRE,91.2% for biopsy combined TRUS and 76.5% for biopsy combined MRI.Conclusion:Of three noninvasive diagnosis methods,TRUS has better detection efficiency,which combined with biopsy can obviously reduce the missed diagnosis rate on PCA with PSA in gray zone.更多还原