Huang Shih-Tsung, Hsieh Ming-Li
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital-Linkou, Chang Gung University, College of Medicine, Taoyuan, Taiwan, ROC.
Anticancer Res. 2008 Jul-Aug;28(4A):1985-8.
The purpose of this study was to evaluate the relationship of the resistance index (RI) of the prostate measured by transrectal ultrasonography (TRUS) in Taiwanese prostate cancer patients to Gleason score, staging and prostate volume.
Forty-five patients (mean age, 73.3 years; range 56 to 97) diagnosed to have prostate cancer via prostate biopsy and/or transurethral prostatectomy were recruited for our study. The patients were divided into 3 groups according to Gleason score, low grade (2-4, LG n = 14), intermediate grade (5-7, IG n = 14) and high grade (8-10, HG n = 17) groups. The blood flow pattern and mean RI of the prostate vessels were recorded and compared with age, prostate volume, serum prostate specific antigen (PSA) and oncological stage. A follow-up color Doppler ultrasonography was also performed in 17 patients after 3-6 months of hormone therapy and the changes of RI were recorded.
The mean age, serum PSA and prostate volume were comparative among the three groups, but the differences of RI were statistically significant (p = 0.029). Advanced prostate cancer (HG group) tended to have higher RI. There was a close correlation between RI and Gleason score (Spearman R = 0.452, p = 0.002). The high RI phenomenon could be reversed after 3-6 months of hormone therapy (paired t-test, p < 0.05).
High grade prostate cancer tends to have higher RI. RI measurement during color Doppler TRUS may be helpful in the evaluation of the vascularity of prostate cancer and its vascular changes to hormone treatment.
本研究旨在评估经直肠超声检查(TRUS)测量的台湾前列腺癌患者前列腺阻力指数(RI)与Gleason评分、分期及前列腺体积之间的关系。
本研究招募了45例经前列腺活检和/或经尿道前列腺切除术诊断为前列腺癌的患者(平均年龄73.3岁;范围56至97岁)。根据Gleason评分将患者分为3组,低级别组(2 - 4分,LG,n = 14)、中级别组(5 - 7分,IG,n = 14)和高级别组(8 - 10分,HG,n = 17)。记录前列腺血管的血流模式和平均RI,并与年龄、前列腺体积、血清前列腺特异性抗原(PSA)及肿瘤分期进行比较。17例患者在接受3 - 6个月激素治疗后还进行了彩色多普勒超声随访,并记录RI的变化。
三组患者的平均年龄、血清PSA和前列腺体积具有可比性,但RI差异具有统计学意义(p = 0.029)。晚期前列腺癌(HG组)往往具有较高的RI。RI与Gleason评分之间存在密切相关性(Spearman相关系数R = 0.452,p = 0.002)。3 - 6个月激素治疗后,高RI现象可逆转(配对t检验,p < 0.05)。
高级别前列腺癌往往具有较高的RI。彩色多普勒TRUS测量RI可能有助于评估前列腺癌的血管情况及其对激素治疗的血管变化。