Colleselli Daniela, Bektic Jasmin, Schaefer Georg, Frauscher Ferdinand, Mitterberger Michael, Brunner Andrea, Schwentner Christian, Bartsch Georg, Horninger Wolfgang, Pelzer Alexandre E
Department of Urology, University of Innsbruck, Innsbruck, Austria.
BJU Int. 2007 Dec;100(6):1264-7. doi: 10.1111/j.1464-410X.2007.07174.x. Epub 2007 Sep 10.
To evaluate the influence of prostate volume (PV) on the detection of prostate cancer using a combined approach of contrast-enhanced ultrasonography (CEUS) and grey-scale US-guided systematic biopsy (SB).
We evaluated 345 patients with prostate cancer and a total prostate-specific antigen (PSA) level of >/= 1.32 ng/mL (1.32-35.3, mean 6.6). Biopsies were taken by two independent examiners; one took five CEUS (Doppler) targeted biopsies of hypervascular regions in the peripheral zone, and subsequently the other took 10 systematic prostate biopsies. We assessed the cancer detection rates for the five different subgroups of prostate volumes, i.e. <20, 20-30, 30-40, 40-50 and > 50 mL.
Each technique, SB and CEUS, detected 73.4% and 77.1% of all detected cancers, respectively, but there were statistically significant differences in detection rate only in small glands. Only 69.0% and 70.4% of all cancers were detected by SB in glands of <20 and 20-30 mL, respectively, whereas 88.1% and 80.8% were detected by CEUS.
The prostate cancer detection rate for CEUS was significantly higher in prostates of <30 mL (48.1% of the study population) than for SB. Therefore the combined approach of CEUS and SB allows improved cancer detection in patients with small glands and low total PSA values.
采用对比增强超声（CEUS）与灰阶超声引导下系统活检（SB）相结合的方法，评估前列腺体积（PV）对前列腺癌检测的影响。
我们评估了345例前列腺癌患者，其总前列腺特异性抗原（PSA）水平≥1.32 ng/mL（1.32 - 35.3，平均6.6）。活检由两名独立的检查者进行；一名检查者对周边区高血运区域进行5次CEUS（多普勒）靶向活检，随后另一名检查者进行10次系统前列腺活检。我们评估了前列腺体积的五个不同亚组（即<20、20 - 30、30 - 40、40 - 50和>50 mL）的癌症检测率。
SB和CEUS这两种技术分别检测出所有检测到癌症的73.4%和77.1%，但仅在小腺体中检测率存在统计学显著差异。在<20 mL和20 - 30 mL的腺体中，SB分别仅检测出所有癌症的69.0%和70.4%，而CEUS分别检测出88.1%和80.8%。
对于<30 mL的前列腺（占研究人群的48.1%），CEUS的前列腺癌检测率显著高于SB。因此，CEUS与SB相结合的方法可提高小腺体且总PSA值低的患者的癌症检测率。
