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目的 探讨临床分期和磁共振成像(MRI)分期预测前列腺癌病理分期的临床意义。方法 对32例病理证实的局限性前列腺癌行根治性手术前经直肠指诊进行临床分期及MRI分期预测术后前列腺病理分期结果,评价其预测前列腺癌病理分期的诊断性结果。结果 本组32例前列腺癌中,临床分期局限于前列腺内的肿瘤(B期)30例,10例前列腺癌根治术后病理诊断有前列腺包膜及包膜外浸润,1例左髂血管旁淋巴结转移癌,36.7％(11/30)病例临床分期偏低,2例临床分期为C期病例术后1例为B期,临床分期偏高。而MRI诊断的30例前列腺癌中,分期局限于前列腺内的肿瘤(B期)21例中,4例前列腺根治术后病理诊断为C期,19.1％(4/21)的病例MRI分期偏低;9例MRI分期为C期病例1例术后为B期,分期偏高,另1例术后为D1期,分期偏低。直肠指诊临床分期和MRI分期预测前列腺癌的病理结果有显著相关性(P=0.002)。临床分期和MRI分期对局限于前列腺内肿瘤的预测(PPV)分别为63.3％和80.9％;对浸润包膜及包膜外肿瘤的预测(NPV)分别为50.0％和88.9％。MRI对前列腺癌病理分期的预测更具有特异性和较高的准确性,能更好的预测前列腺癌的病理结果(P=0.023)。结论 MRI分期较直肠指诊临床分期能更好地预测局限于前列腺内的肿瘤,对前列腺包膜及包膜以外浸润的肿瘤能进行更准确分
Objective To investigate the clinical significance of clinical staging and magnetic resonance imaging (MRI) staging in predicting the staging of prostate cancer. Methods 32 cases of localized prostate cancer confirmed pathologically confirmed by radical prostatectomy before surgery were staged and MRI staging to predict postoperative pathological staging results of prostate cancer to evaluate the prognosis of the diagnosis of prostate cancer staging results. Results Of the 32 cases of prostate cancer, the clinical stage was limited to 30 cases of prostate cancer (stage B), 10 cases of prostate cancer with pathological diagnosis of prostate capsule and extracapsular infiltration, 1 case of left iliac plexus lymph node Metastasis of cancer, 36.7% (11/30) cases of clinical stage low, 2 cases of clinical stage C case 1 case after the B stage, high clinical stage. Among the 30 cases of prostate cancer diagnosed by MRI, staging was confined to 21 cases of prostate cancer (stage B), 4 cases of prostatectomy were diagnosed as C stage, and 19.1% (4/21) of cases had low staging of MRI ; 9 cases of MRI staging for the C case 1 case of postoperative B period, the high stage, the other one after the stage of D1, the stage is low. There was a significant correlation between clinical stage and MRI staging in predicting the pathologic findings of prostate cancer (P = 0.002). The clinical stage and MRI staging were 63.3% and 80.9%, respectively. The predictive value (PPV) of the tumors within the prostate was 50.0% and 88.9%, respectively. MRI is more specific and accurate in predicting the pathological staging of prostate cancer, and can better predict the pathological results of prostate cancer (P = 0.023). Conclusion MRI staging can predict the tumor confined to the prostate better than the clinical staging of the digital rectal examination and can be used to more accurately distinguish the prostatic capsule and the tumor infiltrating from the capsule