剪切波彈性成像對(duì)前列腺增生病理類型診斷的初步研究
發(fā)布時(shí)間：2019-02-24 16:49
【摘要】：目的：通過(guò)經(jīng)直腸剪切波彈性超聲成像檢測(cè)BPH患者前列腺移行區(qū)的彈性模量,分析彈性模量與前列腺增生病理類型的相關(guān)性,判斷前列腺增生的病理類型,為臨床藥物治療BPH提供參數(shù)指導(dǎo),同時(shí)試圖尋找前列腺移行區(qū)彈性模量、病理類型與臨床參數(shù)之間的關(guān)系,為前列腺增生的診療提供新的理論依據(jù)。 方法：收集2013年7月到2014年1月在中南大學(xué)湘雅醫(yī)學(xué)院附屬海口醫(yī)院泌尿外科行經(jīng)尿道前列腺電切術(shù)BPH患者前列腺標(biāo)本共37例。記錄患者IPSS評(píng)分、tPSA、fPSA。對(duì)37例患者行TURS及經(jīng)直腸剪切波彈性成像檢查,測(cè)量前列腺體積以及前列腺移行區(qū)彈性模量平均值。HE染色結(jié)合Image-pro plus6.0軟件觀察分析判斷BPH增生病理類型。相關(guān)數(shù)據(jù)用SPSS19.0統(tǒng)計(jì)軟件分析。計(jì)量資料兩組間均數(shù)的比較用t檢驗(yàn)。通過(guò)彈性模量值繪制ROC曲線,根據(jù)約登指數(shù)來(lái)確定判斷前列腺增生病理類型的彈性模量值的最佳截?cái)帱c(diǎn)。變量間的相關(guān)性檢驗(yàn)Pearson相關(guān)系數(shù)表示。P0.05為差異有統(tǒng)計(jì)學(xué)意義。 結(jié)果： 1.HE染色結(jié)果：腺體增生為主的BPH12例,間質(zhì)增生為主BPH25例； 2.間質(zhì)增生為主的BPH組與腺體增生為主的BPH組的彈性模量差異比較具有統(tǒng)計(jì)學(xué),間質(zhì)增生為主的BPH組的彈性模量(34.93±8.318)KPa明顯高于腺體增生為主的BPH組(24.54±3.816) KPa。(F=3.821,P=0.059, t=-4.100,P0.001). 3.根據(jù)ROC曲線統(tǒng)計(jì)分析,彈性模量值的最佳截?cái)帱c(diǎn)為27.45KPa, AUC=0.935,約登指數(shù)為0.753,靈敏度為92.0%,特異度為83.3%,準(zhǔn)確度為89.2%； 4.間質(zhì)增生為主的BPH組的與腺體增生為主的BPH組的tPSA、fPSA、IPSS、體積統(tǒng)計(jì)比較分析中均有統(tǒng)計(jì)學(xué)意義,間質(zhì)增生為主的BPH組的tPSA濃度(2.15±0.769)ng/ml、fPSA濃度(0.54±0.292) ng/ml、體積(41.25±15.233)cm3低于腺體增生為主的BPH組tPSA濃度(4.93±2.673)ng/ml、fPSA濃度(1.12±0.529)ng/ml、體積(69.05±13.173)cm3。間質(zhì)增生為主的BPH組IPSS評(píng)分(27.00±3.136)分高于BPH組(22.92±2.466)分。 5.彈性模量與IPSS(r=0.468,p=0.004)為正相關(guān)、與tPSA(r=-0.346,p=0.036).fPSA(r=-0.421,p=0.009)、體積(r=-0.732,p0.001)為負(fù)相關(guān)。 結(jié)論： 1.剪切波彈性成像技術(shù)對(duì)判斷前列腺增生的病理類型具有一定的診斷價(jià)值。本研究彈性模量最佳診斷截點(diǎn)為27.45KPa。 2.不同病理類型的BPH其臨床特點(diǎn)不同。間質(zhì)增生為主的BPH患者的臨床特點(diǎn)為：彈性模量值較高、體積偏小、PSA水平較低、癥狀較重。腺體增生為主的BPH患者的臨床特點(diǎn)與之相反。
[Abstract]:Objective: to detect the modulus of elasticity in the transitional zone of prostate in patients with BPH by transrectal shear wave elastography, and to analyze the correlation between the modulus of elasticity and the pathological type of benign prostatic hyperplasia (BPH), and to judge the pathological type of BPH. It provides parameter guidance for clinical drug therapy of BPH, and tries to find out the relationship among the elastic modulus, pathological type and clinical parameters in the transitional zone of prostate, thus providing a new theoretical basis for the diagnosis and treatment of prostatic hyperplasia. Methods: from July 2013 to January 2014, 37 prostate specimens were collected from patients undergoing transurethral resection of the prostate (BPH) in the Department of Urology, affiliated Haikou Hospital, Xiangya Medical College, Central South University. Record patient IPSS score, tPSA,fPSA. TURS and transrectal shear wave elastography were performed in 37 patients. The volume of prostate and the mean elastic modulus of the transitional area of prostate were measured. The pathological types of BPH hyperplasia were determined by HE staining and Image-pro plus6.0 software. The related data were analyzed by SPSS19.0 statistical software. T test was used to compare the mean between the two groups. The ROC curve was drawn by the elastic modulus value and the best cut-off point for judging the elastic modulus value of the pathological type of benign prostatic hyperplasia was determined according to the Jorden index. The correlation test between variables Pearson correlation coefficient expression. P0.05 for the difference was statistically significant. Results: the results of 1.HE staining were as follows: BPH12 with glandular hyperplasia, BPH25 with interstitial hyperplasia and 2. The difference of elastic modulus between BPH group and BPH group was statistically significant. The elastic modulus of BPH group (34.93 鹵8.318) KPa was significantly higher than that of BPH group (24.54 鹵3.816) KPa. (FN 3.821 P0. 059, t0. 100% P0. 001). 3. According to the statistical analysis of ROC curve, the best cut-off point of elastic modulus value is 27.45 KPA, the AUC=0.935, Yorden index is 0.753, the sensitivity is 92.0, the specificity is 83.3, the accuracy is 89.2KPA; There was significant difference in the volume of tPSA,fPSA,IPSS, between BPH group and BPH group. The tPSA concentration of BPH group with interstitial hyperplasia was (2.15 鹵0.769) ng/ml,. FPSA concentration (0.54 鹵0.292) ng/ml, volume (41.25 鹵15.233) cm3 was lower than that in glandular hyperplasia BPH group (4.93 鹵2.673) ng/ml,fPSA concentration (1.12 鹵0.529) ng/ml, volume (69.05 鹵13.173) cm3.. The IPSS score of BPH group (27.00 鹵3.136) was higher than that of BPH group (22.92 鹵2.466). 5. The elastic modulus was positively correlated with IPSS (r = 0.468) and negatively correlated with tPSA (r ~ (-0.344). FPSA (~ (0.036). FPSA (~ (-0.421). FPSA (~ (0.009) and volume (r ~ (-0.732) / p ~ (0.001). Conclusion: 1. Shear wave elastography is valuable in the diagnosis of benign prostatic hyperplasia (BPH). The best diagnostic cut-off point of elastic modulus in this study is 27.45 KPA. 2. Different pathological types of BPH have different clinical characteristics. The clinical features of BPH patients with interstitial hyperplasia were high elastic modulus, small volume, low PSA level and severe symptoms. The clinical characteristics of BPH patients with glandular hyperplasia were opposite.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R697.3
本文編號(hào)：2429738
[Abstract]:Objective: to detect the modulus of elasticity in the transitional zone of prostate in patients with BPH by transrectal shear wave elastography, and to analyze the correlation between the modulus of elasticity and the pathological type of benign prostatic hyperplasia (BPH), and to judge the pathological type of BPH. It provides parameter guidance for clinical drug therapy of BPH, and tries to find out the relationship among the elastic modulus, pathological type and clinical parameters in the transitional zone of prostate, thus providing a new theoretical basis for the diagnosis and treatment of prostatic hyperplasia. Methods: from July 2013 to January 2014, 37 prostate specimens were collected from patients undergoing transurethral resection of the prostate (BPH) in the Department of Urology, affiliated Haikou Hospital, Xiangya Medical College, Central South University. Record patient IPSS score, tPSA,fPSA. TURS and transrectal shear wave elastography were performed in 37 patients. The volume of prostate and the mean elastic modulus of the transitional area of prostate were measured. The pathological types of BPH hyperplasia were determined by HE staining and Image-pro plus6.0 software. The related data were analyzed by SPSS19.0 statistical software. T test was used to compare the mean between the two groups. The ROC curve was drawn by the elastic modulus value and the best cut-off point for judging the elastic modulus value of the pathological type of benign prostatic hyperplasia was determined according to the Jorden index. The correlation test between variables Pearson correlation coefficient expression. P0.05 for the difference was statistically significant. Results: the results of 1.HE staining were as follows: BPH12 with glandular hyperplasia, BPH25 with interstitial hyperplasia and 2. The difference of elastic modulus between BPH group and BPH group was statistically significant. The elastic modulus of BPH group (34.93 鹵8.318) KPa was significantly higher than that of BPH group (24.54 鹵3.816) KPa. (FN 3.821 P0. 059, t0. 100% P0. 001). 3. According to the statistical analysis of ROC curve, the best cut-off point of elastic modulus value is 27.45 KPA, the AUC=0.935, Yorden index is 0.753, the sensitivity is 92.0, the specificity is 83.3, the accuracy is 89.2KPA; There was significant difference in the volume of tPSA,fPSA,IPSS, between BPH group and BPH group. The tPSA concentration of BPH group with interstitial hyperplasia was (2.15 鹵0.769) ng/ml,. FPSA concentration (0.54 鹵0.292) ng/ml, volume (41.25 鹵15.233) cm3 was lower than that in glandular hyperplasia BPH group (4.93 鹵2.673) ng/ml,fPSA concentration (1.12 鹵0.529) ng/ml, volume (69.05 鹵13.173) cm3.. The IPSS score of BPH group (27.00 鹵3.136) was higher than that of BPH group (22.92 鹵2.466). 5. The elastic modulus was positively correlated with IPSS (r = 0.468) and negatively correlated with tPSA (r ~ (-0.344). FPSA (~ (0.036). FPSA (~ (-0.421). FPSA (~ (0.009) and volume (r ~ (-0.732) / p ~ (0.001). Conclusion: 1. Shear wave elastography is valuable in the diagnosis of benign prostatic hyperplasia (BPH). The best diagnostic cut-off point of elastic modulus in this study is 27.45 KPA. 2. Different pathological types of BPH have different clinical characteristics. The clinical features of BPH patients with interstitial hyperplasia were high elastic modulus, small volume, low PSA level and severe symptoms. The clinical characteristics of BPH patients with glandular hyperplasia were opposite.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R697.3
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 張倩倩;王學(xué)梅;李銀燕;耿晶;張義俠;李響;康姝;;剪切波彈性成像在乳腺良惡性病變鑒別診斷中的價(jià)值[J];中國(guó)臨床醫(yī)學(xué)影像雜志;2012年06期
，本文編號(hào)：2429738
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