摘要
目的探讨前列腺癌Gleason 3+4和Gleason 4+3患者超声造影参数与前列腺组织中转化生长因子-β1(transforming growth factor-beta 1,TGF-β1)的相关性。方法中度风险前列腺癌(Gleason=7分)患者87例,均行经直肠超声造影检查和前列腺穿刺活检组织病理检查,根据组织病理学结果分为Gleason 3+4组42例和Gleason 4+3组45例;比较2组超声造影参数及前列腺组织中TGF-β1表达情况,分析超声造影参数与TGF-β1的相关性,绘制ROC曲线,评估各指标区分Gleason 3+4与Gleason 4+3前列腺癌的诊断效能。结果Gleason 4+3组超声造影病灶峰值强度[(9.60±2.81)dB]、AUC[(606.93±284.55)dBs]大于Gleason 3+4组[(7.24±2.19)dB、(412.53±164.35)dBs](P<0.05),Gleason 4+3组前列腺组织TGF-β1的高表达率(55.6%)高于Gleason 3+4组(31.0%)(P<0.05);TGF-β1与造影参数的峰值强度(r=0.537,P<0.001)、平均渡越时间(r=0.281,P=0.008)、AUC(r=0.607,P<0.001)、强度降半时间(r=0.380,P<0.001)呈正相关,与上升时间(r=0.124,P=0.254)、上升支斜率(r=0.126、P=0.243)、达峰时间(r=-0.076,P=0.485)无相关性;当病灶峰值强度、AUC的最佳截断值分别>9.19 dB、>582.84 dBs以及TGF-β1高表达时,区分前列腺癌组织学评分Gleason 3+4与Gleason 4+3的AUC分别为0.753(95%CI:0.649~0.839,P<0.001)、0.730(95%CI:0.624~0.819,P<0.001)、0.612(95%CI:0.501~0.750,P<0.001),灵敏度、特异度分别为62.2%、85.71%,53.33%、92.86%,53.33%、69.05%。结论超声造影参数可反映前列腺癌血管灌注情况,前列腺组织TGF-β1表达情况和超声造影参数对评估中等风险前列腺癌患者预后有一定价值。
Objective To investigate the correlation between contrast-enhanced ultrasound parameters and transforming growth factor-β1(TGF-β1)in patients with prostate cancer Gleason 3+4 and Gleason 4+3.Methods Eighty-seven patients with moderate-risk prostate cancer(Gleason=7)underwent transrectal contrast-enhanced ultrasound and prostate biopsy and were divided into Gleason 3+4 group(n=42)and Gleason 4+3 group(n=45)according to the histopathologic results.The contrast-enhanced ultrasound parameters and the expression of TGF-β1 in prostate tissues were compared between two groups.The correlation between the contrast-enhanced ultrasound parameters and TGF-β1 was analyed.The efficiency on distinguishing Gleason 3+4 from Gleason 4+3 prostate cancer was evaluated by ROC.Results The peak intensity and AUC of contrast-enhanced ultrasound were larger in Gleason 4+3 group((9.60±2.81)dB,(606.93±284.55)dBs)than those in Gleason 3+4 group((7.24±2.19)dB,(412.53±164.35)dBs)(P<0.05),and the high expression rate of TGF-β1 in prostate tissue was higher in Gleason 4+3 group(55.6%)than that in Gleason 3+4 group(31.0%)(P<0.05).TGF-β1 was positively correlated with the peak intensity(r=0.537,P<0.001),mean transit time(r=0.281,P=0.008),AUC(r=0.607,P<0.001)and half time of descending(r=0.380,P<0.001),and not correlated with the rise time(r=0.124,P=0.254),wash in slope(r=0.126,P=0.243),and time to peak(r=-0.076,P=0.485).When the optimal cut-off values of peak intensity,AUC and TGF-β1 were>9.19 dB,>582.84 dBs and TGF-β1 high expression,the AUCs for distinguishing Gleason 3+4 from Gleason 4+3 were 0.753(95%CI:0.649-0.839,P<0.001),0.730(95%CI:0.624-0.819,P<0.001),and 0.612(95%CI:0.501-0.750,P<0.001),with the sensitivities of 62.2%,53.33%and 53.33%and specificities of 85.71%,92.86%and 69.05%.Conclusion Contrast-enhanced ultrasound parameters can reflect the vascular perfusion of prostate cancer.The expression of TGF-β1 in prostate tissue and the contrast-enhanced ultrasound parameters are of certain value in assessing the prognosis of patients with moderate-risk prostate cancer.
作者
解天
梁丹艳
刘倩
红华
XIE Tian;LIANG Danyan;LIU Qian;HONG Hua(Grade 2017,Inner Mongolia Medical University,Hohhot 010059,China;Department of Ultrasound,People's Hospital of Inner Mongolia Autonomous Region,Hohhot 010017,China)
出处
《中华实用诊断与治疗杂志》
2020年第4期404-407,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
内蒙古自治区自然科学基金项目(2015MS08141)。
关键词
前列腺癌
超声造影
转化生长因子-Β1
prostate cancer
contrast-enhanced ultrasound
transforming growth factor-β1
作者简介
通信作者:红华,E-mail:6622306hong@163.com。
