临床误诊误治2023，Vol.36Issue(9)：22-27,33,7.DOI:10.3969/j.issn.1002-3429.2023.09.006
超声引导下经直肠前列腺穿刺活检漏诊前列腺癌患者临床特征及原因分析
Clinical Characteristics and Cause of Missed Diagnosis of Prostate Cancer by Ultrasound-guided Transrectal Prostate Biopsy
樊丽丽 1兰琦玉 1毛玲玲 1郭龚映 1邓红梅 1吴杭2
作者信息
- 1. 610100 成都,四川护理职业学院附属医院 四川省第三人民医院超声科
- 2. 629000 四川 遂宁,遂宁市第一人民医院超声介入科
- 折叠
摘要
Abstract
Objective To investigate the clinical characteristics and causes of missed diagnosis of prostate cancer by ultrasound-guided transrectal prostate biopsy.Methods A total of 80 patients with suspected prostate cancer admitted from July 2021 to March 2023 were selected and divided into non-consistency group(n =31)and consistency group(n =49)ac-cording to consistency of the results of ultrasound-guided transrectal prostate biopsy and postoperative pathological examina-tion.The clinical data of the two groups were compared.Multivariate Logistic regression analysis was used to explore the influ-encing factors of missed prostate cancer by ultrasound-guided transrectal prostate biopsy.The nomogram prediction model of missed prostate cancer by ultrasound-guided transrectal prostate biopsy was constructed by R3.3.2 software and rms software package.Receiver operating characteristic(ROC)curve,calibration curve and clinical decision curve were used to evaluate the diagnostic efficiency of the predictive model.Results Age,prostate-specific antigen(PSA),PSA density(PSAD),proportion of positive direct rectal examination(DRE)results,proportion of positive transrectal ultrasound(TRUS)examina-tion results,and proportion of prostate imaging reporting and data system(PI-RADS)score≥4 were lower in the non-consistency group than in the consistency group,while the prostate volume(PV)was larger than that of the consistency group(P＜0.05,P＜0.01).Results of multivariate Logistic regression analysis showed that age,PSA,PV,DRE and PI-RADS score were independent risk factors for missed diagnosis of prostate cancer in ultrasound-guided transrectal prostate biopsy(P＜0.05,P＜0.01).The nomogram prediction model built based on risk factors predicted that the probability of missing prostate cancer by ultrasound-guided transrectal prostate biopsy was 82.00%,and the ROC curve showed that the area under the ROC curve was 0.836(95%CI 0.786,0.899),the sensitivity was 81.20%,and the specificity was 77.40%.Calibra-tion curve and clinical decision curve showed that the prediction model had high accuracy,effectiveness and clinical practica-bility.Conclusion Ultrasound-guided transrectal prostate biopsy has a high rate of missed diagnosis of prostate cancer.Age,PSA,PV,DRE and PI-RADS score are independent risk factors for missed diagnosis of prostate cancer.Therefore,the num-ber of biopsy samples of the above risk factors should be increased to reduce the risk of missed diagnosis of prostate cancer.关键词
前列腺肿瘤/活组织检查,针吸/超声引导/术后病理/漏诊/临床特征/列线图/受试者工作特征曲线Key words
Prostatic neoplasms/Biopsy,needle/Ultrasound-guided/Postoperative pathology/Missed diagnosis/Clinical characteristics/Nomograms/Receiver operating characteristic curve分类
临床医学引用本文复制引用
樊丽丽,兰琦玉,毛玲玲,郭龚映,邓红梅,吴杭..超声引导下经直肠前列腺穿刺活检漏诊前列腺癌患者临床特征及原因分析[J].临床误诊误治,2023,36(9):22-27,33,7.
