| 杨留洋,贾招辉,潘 冬,卞 盼,张 伟,窦中岭.侵袭性前列腺癌的CT、MRI表现与生物因子表达及淋巴结转移的相关性研究[J].,2022,(9):1779-1784 |
| 侵袭性前列腺癌的CT、MRI表现与生物因子表达及淋巴结转移的相关性研究 |
| Correlation Study of CT, MRI Manifestations of Invasive Prostate Cancer with Expression of Biological Factors and Lymph Node Metastasis |
| 投稿时间：2021-09-23 修订日期：2021-10-17 |
| DOI：10.13241/j.cnki.pmb.2022.09.036 |
| 中文关键词: 侵袭性前列腺癌 CT MRI 生物因子 淋巴结转移 相关性 |
| 英文关键词: Invasive prostate cancer CT MRI Biological factors Lymph node metastasis Correlation |
| 基金项目:河南省医学科技攻关项目计划省部共建项目（SBGJ2018060） |
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| 中文摘要: |
| 摘要 目的：探讨侵袭性前列腺癌的电子计算机断层扫描（CT）、磁共振成像（MRI）表现与生物因子表达及淋巴结转移的相关性研究。方法：收集2016年2月-2021年2月于我院确诊前列腺癌患者117例，所以患者均行前列腺根治切除+盆腔淋巴结清扫术，术前均完善CT、MRI影像学检查，根据术后病理结果、Gleason评分分为侵袭性前列腺癌组（63例）和非侵袭性前列腺癌组（54例），分析患者CT、MRI表现特征。采用免疫组织化学染色分析前列腺特异抗原（PSA）、增殖细胞核抗原（PCNA）、血管内皮生长因子（VEGF）、细胞核增殖相关抗原 (Ki-67)及肿瘤抑制蛋白（P53）的阳性表达情况。分析侵袭性前列腺癌的CT、MRI表现与生物因子表达及淋巴结转移之间的关系。结果：侵袭性前列腺癌患者CT、MRI均可见不同程度的前列腺异常改变，主要表现为结节状、波浪状突起，边缘模糊、毛糙，前列腺癌突破包膜并累及邻近精囊腺、膀胱、直肠及周围脂肪组织，可见盆腔肿大淋巴结转移，测量表观扩散系数（ADC）值及动态增强MRI定量参数可大致区分病灶良恶性及恶性程度分级情况。侵袭性前列腺癌组PSA的表达低于非侵袭性前列腺癌组，而PCNA、VEGF、Ki-67、P53的表达及淋巴结转移高于非侵袭性前列腺癌组，差异均有统计学意义（P＜0.05）。侵袭性前列腺癌患者肿瘤边缘表现为模糊、清晰时PSA、PCNA阳性表达率及淋巴结转移率组间差异均有统计学意义（P＜0.05）；肿瘤直径≤2 cm、＞2 cm时的淋巴结转移率组间差异具有统计学意义（P＜0.05）。侵袭性前列腺癌组ADC值低于非侵袭性前列腺癌组，而Kep和Ktrans高于非侵袭性前列腺癌组患者，差异均有统计学意义（P＜0.05）。侵袭性前列腺癌患者ADC值与PSA阳性表达呈正相关性（P＜0.05），与PCNA、Ki-67、P53阳性表达及淋巴结转移呈负相关（P＜0.05）。侵袭性前列腺癌患者Kep、Ktrans与PSA阳性表达呈负相关性（P＜0.05），与PCNA、Ki-67、P53阳性表达及淋巴结转移呈正相关（P＜0.05）。结论：侵袭性前列腺癌CT、MRI形态学具有一定特征性，通过测量ADC值及动态增强MRI定量参数可大致区分病灶恶性程度情况，初步评估前列腺癌的生物学行为，为指导临床综合治疗及预后情况提供客观依据。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the correlation between the electronic computed tomography (CT) and magnetic resonance imaging (MRI) manifestations of invasive prostate cancer and the expression of biological factors and lymph node metastasis. Methods: Collected 117 cases of prostate cancer patients diagnosed in our hospital from February 2016 to February 2021. All patients underwent radical prostatectomy+pelvic lymph node dissection. CT and MRI imaging examinations were completed before the operation. According to postoperative pathological results and Gleason score, they were divided into invasive prostate cancer group (63 cases) and non invasive prostate cancer group(54 cases), and the CT and MRI features of the patients were analyzed.Immunohistochemical staining was used to analyze the positive expression of prostate specific antigen (PSA), proliferating cell nuclear antigen (PCNA), vascular endothelial growth factor (VEGF), nuclear proliferation-related antigen (Ki-67) and tumor suppressor protein (P53). Analyze the relationship between the CT and MRI manifestations of invasive prostate cancer and the expression of biological factors and lymph node metastasis. Results: CT and MRI in patients with invasive prostate cancer showed varying degrees of abnormal prostate changes, mainly manifested as nodules, wavy protrusions, fuzzy edges,and roughness. Prostate cancer broke through the capsule and involved adjacent seminal vesicle glands, bladder, rectum and peripheral fat tissue, pelvic enlarged lymph node metastasis can be seen. Measuring the apparent diffusion coefficient(ADC) value and dynamic enhanced MRI quantitative parameters can roughly distinguish the benign, malignant and malignant degree of the lesion. The expression of PSA in the invasive prostate cancer group was lower than that in the non invasive prostate cancer group,while the expression of PCNA, VEGF, Ki-67, P53 and lymph node metastasis were higher than those in the non invasive prostate cancer group,and the differences were statistically significant (P<0.05). The positive expression rate of PSA and PCNA and the lymph node metastasis rate of patients with invasive prostate cancer when the tumor edge was blurred and clear were statistically significant (P<0.05). The difference in lymph node metastasis rate when the tumor diameter was ≤2 cm and >2 cm was statistically significant(P＜0.05). The ADC value of invasive prostate cancer group was lower than that of non invasive prostate cancer group, while Kep and Ktrans were higher than those of non invasive prostate cancer group, the difference were statistically significant(P<0.05). The ADC value of invasive prostate cancer patients was positively correlated with the positive expression of PSA(P＜0.05), and negatively correlated with the positive expression of PCNA, Ki-67, P53 and lymph node metastasis(P＜0.05). The Kep and Ktrans of invasive prostate cancer patients were negatively correlated with the positive expression of PSA(P＜0.05), and positively correlated with the positive expression of PCNA, Ki-67, P53 and lymph node metastasis (P＜0.05). Conclusion: The morphology of CT and MRI of invasive prostate cancer has certain characteristics. By measuring ADC value and dynamic enhanced MRI quantitative parameters, we can roughly distinguish the degree of malignancy of the lesion, preliminarily evaluate the biological behavior of prostate cancer, and provide objective basis for guiding clinical comprehensive treatment and prognosis. |
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