摘要
目的:探索前列腺癌超声造影低增强结节的病理学基础,同时研究前列腺癌低增强结节与Gleason评分的相关性。方法:选取48例经直肠超声造影有异常发现的前列腺外腺结节,并经直肠超声引导穿刺活检病理证实为前列腺癌的患者,按照前列腺癌结节超声造影增强强度分为两组,高增强组36例,低增强/不均匀增强组12例。采用CD34免疫组织化学法,比较两组前列腺癌结节组织血管密度,探索前列腺癌结节超声造影增强强度与血管密度的相关性。结果:48例前列腺外腺癌患者中,超声造影呈高增强结节36例,低增强结节9例,不均匀增强结节3例。高增强组富血管例数占比高于低增强/不均匀增强组,差异有统计学意义(P=0.017),而高增强组Gleason高分值例数占比高于低增强/不均匀增强组,但差异无统计学意义(P=0.061)。Gleason高分值组血管密度高于Gleason低分值组,差异有统计学意义(P=0.046)。低增强和不均匀增强前列腺癌结节部分为少血管结节,部分为富血管结节,呈低增强的富血管结节中多见血管发育程度低,大部分血管未开放。1例前列腺癌组织内见出血、坏死。结论:前列腺癌超声造影高增强结节的血管密度较高,Gleason分值也较高;低增强/不均匀增强结节的血管密度高低不一, Gleason分值也不同;低增强结节部分为少血管,部分为富血管,富血管呈低增强的结节可能与血管发育程度低、开放血管少有关。
Objective:To explore the pathological basis of low-enhancement nodules of prostate cancer on contrast-enhanced ultrasound (CEUS),and to study the correlation between low-enhancement nodules of prostate cancer and Gleason score.Methods: Forty-eight patients with abnormal external glands of the prostate identified by transrectal CEUS were chosen.They underwent transrectal ultrasound-guided biopsy to confirm the pathological diagnosis of prostate cancer.The patients were divided into high-enhancement group (n=36)and low/heterogeneous enhancement group (n=12)according to the contrast enhancement pattern of prostate nodules.The CD34 immunohistochemistry method was used to compare the vascular density in prostate nodules between the two groups.The correlation between the intensity of contrast enhancement and vascular density in prostate nodules was explored. Results:In 48 prostate cancer cases,36 with high-enhancement nodules,9 with low-enhancement nodules,and 3 with heterogeneous enhancement nodules were found by CEUS.The proportion of blood vessel-rich cases in high-enhancement group was higher than that in low/heterogeneous enhancement group,and the difference was statistically significant (P=0.017).The proportion of patients with high Gleason score in high-enhancement group was higher than that in low/heterogeneous enhancement group,but the difference was not statistically significant (P=0.061).The vascular density in high Gleason score group was higher than that in low Gleason score group,and the difference was statistically significant (P=0.046).Some of low and heterogeneous nodules had less blood vessels,and some were rich in blood vessels.The low-enhancement nodules rich in blood vessels often had low degree of vascular development and most of the blood vessels were not open.Bleeding and necrosis were found in one case.Conclusion:On CELTS the high-enhancement nodules of prostate cancer have higher vascular density and Gleason score.The vascular density and Gleason score in low/heterogeneous enhancement nodules are different.Among low-enhancement nodules,some have less blood vessels,and some are rich in blood vessels.Low-enhancement nodules rich in blood vessels might be related to low degree of vascular development and less opened blood vessels.
作者
赵云歆
江怡
姚敏
王健
王颖
姚广力
梅将军
俞家顺
ZHAO Yunxin;JIANG Yi;YAO Min;WANG Jian;WANG Ying;YAO Guangli;MEI Jiangjun;YU Jiashun(Department of Ultrasound,Shanghai Punan Hospital of Pudong New Area,Shanghai 200125,China;Department of Pathology,Shanghai Punan Hospital of Pudong New Area,Shanghai 200125,China;Department of Urology,Shanghai Punan Hospital of Pudong New Area,Shanghai 200125,China)
出处
《肿瘤影像学》
2018年第5期382-386,共5页
Oncoradiology
基金
上海市浦东新区科技发展基金项目(PKJ2015-Y48)
关键词
超声造影
前列腺癌
血管密度
Contrast-enhanced ultrasound
Prostate cancer
Vascular density
