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移行带
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  prostatic transitional zone
    Objective To investigate the sonographic appearance and hemodynamic features of hyperplastic nodules and prostatic cancer nodules in the prostatic transitional zone via color Doppler ultrasonography and to evaluate their clinical significance.
    目的 探讨经直肠彩色多普勒超声对前列腺移行带增生结节和癌结节的诊断价值。
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    The margin from tumor to normal tissue can be presented on STIR, so the masses were bigger on STIR than on T2WI.
    恶性肿瘤呈混杂信号,STIR序列可显示肿瘤浸润性生长的边缘及与正常组织相交形成的移行带,故恶性肿块大于T2WI瘤灶。
    Results In hepatic tumors, the related tumor center was located outside the liver (100%), and the relevant ratio was less than 1/3 in 67.7%, while vague interface was seen in 89.9% of cases.
    结果 肝源性肿瘤相关瘤体中心位于肝外 (10 0 % ) ,相关比值≤ 1/3 ,占 6 7.7% ,移行带模糊占 89.9% ;
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    Conclusions PSAD and PSA-TZ are more accurate in screening the prostatic cancer than PSA in patients with PSA<20 ng·ml -1 and the cut-off value should be adjusted according to the volume of prostate or its transion zone.
    结论 当血清PSA <2 0ng/ml时 ,PSAD及PSA TZ在前列腺癌的筛选中要优于PSA ,但应根据前列腺或移行带体积调整他们的临界值
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    Methods Serum PSA in 69 cases of PCa and 259 cases of benign prostate hyperplasia (BPH) was determinated by Abbot IMX assay and the PSA system such as fPSA/tPSA, PSAV, PSAD and PSAT measured.
    方法 用酶联免疫吸附法测定 6 9例PCa和 2 5 9例良性前列腺增生 (BPH)患者的血清PSA、游离PSA/总PSA (fPSA/tPSA)、PSA速度(PSAV)、PSA密度 (PSAD)和前列腺移行带PSA密度 (PSAT)值。
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    Differential Dignosis Between Prostatic Carcinoma andBenign Hyperplasia by Transrectal Color Doppler Ultrasonography
    经直肠彩色多普勒超声在前列腺移行带增生结节和癌结节中的诊断价值
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Objective To improve the localizing accuracy for massive space occupying lesions in the right upper abdomen.Materials and Methods CT findings in 36 cases with massive space occupying lesions in the right upper abdomen were analyzed. The related tumor center and relevant ratio were designed and used as a localizing sign. The moving direction of the kidney and the appearance of the interface (or the transitional zone) between mass and liver were observed.Results In hepatic tumors, the related tumor center...

Objective To improve the localizing accuracy for massive space occupying lesions in the right upper abdomen.Materials and Methods CT findings in 36 cases with massive space occupying lesions in the right upper abdomen were analyzed. The related tumor center and relevant ratio were designed and used as a localizing sign. The moving direction of the kidney and the appearance of the interface (or the transitional zone) between mass and liver were observed.Results In hepatic tumors, the related tumor center was located outside the liver (100%), and the relevant ratio was less than 1/3 in 67.7%, while vague interface was seen in 89.9% of cases. The related tumor center of non hepatic neoplasm was usually located in the liver (81.5%), and the relevant ratio was larger than 0.45 in 81.5% of cases, while clear transitional zone could be found in 95.6% of cases, with the fatty line being demonstrated in a few cases. Usually, the right kidney was displaced backward and downward in adrenal neoplasm, while displaced forward and medially in retroperitoneal neoplasm, and displaced backward in hepatic neoplasm.Conclusion The related tumor center and the relevant ratio are the important localized signs for the hepatic or non hepatic massive space occupying lesions in the right upper abdomen. The displace direction of the kidney and the transitional zone are important supplementary signs for localization. Based on these four key points, it is possible to improve the localizing accuracy for massive space occupying lesions in the right upper abdomen. The relation of the lesions with the diaphragm or the crura of diaphragm is used for localizing thoracic or abdominal lesions.

目的 提高对右上腹占位病变定位诊断的准确性。材料与方法 对随机搜集的 36例右上腹巨大占位病变的CT资料进行分析。制定肿物相关瘤体中心及相关比值的标准并作为定位征象 ,观察肾脏移位方向及肿瘤与器官间界面的移行带改变。结果 肝源性肿瘤相关瘤体中心位于肝外 (10 0 % ) ,相关比值≤ 1/3 ,占 6 7.7% ,移行带模糊占 89.9% ;非肝源性肿瘤相关瘤体中心多位于肝内 (81.5 % ) ,相关比值≥ 0 .45 ,占 81.5 % ,移行带清楚占 95 .6 % ,少数病例可见脂肪线。肾上腺源性肿物多使肾脏向后向下移位 ;腹膜后源性肿物多使肾脏向前向内移位 ;肝源性肿物多使肾脏向后移位。结论 相关瘤体中心与相关比值是右上腹肝源性及非肝源性巨大占位病变的重要定位征象 ;肾脏移位方向及移行带的表现是右上腹肿物定位的重要辅助诊断征象。根据 4项观察可提高右上腹肿物的定位准确性。鉴别胸腔或腹部肿物定位征象是膈肌或膈肌脚的位置

Objective To evaluate the prostate specific antigen density of the transition zone in detecting prostate cancer. Methods Serum PSA was determined by the Abbott IMX assay,the volumes of entire prostate and the transition zone were determined by transrectal ultrasound, the total prostate PSA density (PSAD) and prostate specific antigen density of the transition zone (PSAT) were calculated.Of the 118 patients,30 had prostate cancer and 88 BPH. Results With PSA in the range of 4~10 ng/ml,the total prostate...

Objective To evaluate the prostate specific antigen density of the transition zone in detecting prostate cancer. Methods Serum PSA was determined by the Abbott IMX assay,the volumes of entire prostate and the transition zone were determined by transrectal ultrasound, the total prostate PSA density (PSAD) and prostate specific antigen density of the transition zone (PSAT) were calculated.Of the 118 patients,30 had prostate cancer and 88 BPH. Results With PSA in the range of 4~10 ng/ml,the total prostate PSA density in subjects with PCa was 0.26±0.11 where as it was 0.13±0.06 in patients with PBH,PSAT was 1.04±0.70 in PCa and 0.21±0.1 in BPH ( P <0.01).If a total prostate PSA density of 0.15 had been chosen as the cutoff value cancer detection might be missed in 27% of the patients compared to only 9% if the cutoff value was set to 0.35 for PSA density of the transition zone ( P <0.01). Conclusions The prostate specific antigen density of the transition zone is a new effective parameter in detecting prostate cancer.With a PSA range of 4~10 ng/ml,PSAT is much more accurate in detecting prostate cancer than PSAD.

目的 评价前列腺移行带特异抗原密度 (PSAT)检测前列腺癌 (PCa)的临床价值。 方法 用酶免法测定 30例PCa及 88例良性前列腺增生症 (BPH)患者血清PSA水平 ,用经直肠前列腺B超测定患者总前列腺体积及移行带体积 ,并计算PSA密度 (PSAD)及PSAT值。 结果 PSA在 4~ 10ng/ml时 ,PCa和BPH患者PSAD值分别为 0 .2 6± 0 .11、0 .13± 0 .0 6 ,两组间相比差别具有显著性意义 (P <0 .0 1) ;PSAT值则分别为 1.0 4± 0 .70、0 .2 1± 0 .13 ,两组间相比差别具有显著性意义 (P <0 .0 1)。若选择PSAD =0 .15作为判断患者是否需穿刺活检的标准 ,将有 2 7%的PCa漏诊 ,而若选择PSAT =0 .35作为判断患者是否需穿刺活检的标准 ,只有 9%的PCa漏诊 (P <0 .0 1)。 结论 PSAT是一种新的有效的检测PCa的方法 ,PSA在 4~ 10ng/ml范围时 ,用PSAT检测PCa较用PSAD更精确。

Objective To study the pathomorphologic features and causes for misdiagnosis and missed diagnosis of clinical stage A prostate carcinoma. Methods Prostate samples from a seies of 1 020 prostate resections performed in five Shanghai hospitals were obtained, from which 50 clinical stage A carcinoma were studied by immunohistochemistry, according to tumor differentiation and their volume, they were divided into stage A1 and A2 disease. The pathomorphologic features of stage A1 and A2 disease were compared, and...

Objective To study the pathomorphologic features and causes for misdiagnosis and missed diagnosis of clinical stage A prostate carcinoma. Methods Prostate samples from a seies of 1 020 prostate resections performed in five Shanghai hospitals were obtained, from which 50 clinical stage A carcinoma were studied by immunohistochemistry, according to tumor differentiation and their volume, they were divided into stage A1 and A2 disease. The pathomorphologic features of stage A1 and A2 disease were compared, and the causes for misdiagnosis were analysed. Results Stage A1 cancer were well- or moderately well-differentiated, of low volume and tended to be multifocal; Stage A2 cancers were poorly differentiated, of high volume, diffuse infiltration and with high grade prostatic intraepithelial neoplasia. 8 cases were misdiagnosed of which 7 cases were stage A1 and misdiagnosed as benign proliferous small gland lesions and 1 case of A2 disease was misdiagnosed as epithelioid histiocytic reactive proliferation. Conclusions Stage A1 cancer tended to be initiated in the transition zone and the central zone of the hyperplastic prostate. Stage A2 cancers were mostly middle grade to high grade cancers initiated in the peripheral region and then invaded the central area. The lower incidence of stage A carcinoma in China is related to the small amount of biopsy tissue, careless microscopic observation, or lack of the ability to diagnose stage A1 cancer.

目的 探讨临床A期前列腺癌的病理特征 ,并分析其好发部位及漏诊误诊原因。方法 复查上海地区 5所医院 10 2 0份前列腺切除标本 ,通过免疫组织化学SP法检出 5 0例临床A期前列腺癌 ,根据肿瘤分化程度及容量分出A1期癌 12例和A2期癌 38例 ,比较病理形态差异 ,分析A1和A2期癌的漏诊误诊原因。结果 A1期癌以低中级别、低容量、多灶性生长为特点 ,A2期癌以高中级别、高容量、高浸润性伴高级别上皮内新生物为特征。在漏诊误诊的 8例A期癌中 ,A1期癌占 7例 ,均误诊为良性增生性小腺泡病变。A2期癌 1例误诊为反应性上皮样组织细胞增生。结论 A1期癌大多在增生的前列腺移行带和中央带组织易被发现 ,A2期癌可能是大多原发于周围带的高中级别癌浸润至前列腺中央区域。国内A期癌检出率低的原因主要是因为标本取材量少和A1期癌漏诊率较高。

 
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