Gray scale and color Doppler ultrasonography findings in the diagnosis of prostate cancer

Yıl 2019, Cilt: 12 Sayı: 1, 67 - 76, 18.01.2019

Ergin Sağtaş , Mahmut Refik Killi

https://doi.org/10.31362/patd.444308

Öz

Purpose: The aim of this study is to investigate the
relationship between tumoral malignancy potentials and transrectal gray scale
ultrasonographic findings in prostate cancer and to investigate the
contribution of transrectal color Doppler ultrasonography to the diagnosis.

Material
and Methods: We
retrospectively evaluated 63 patients with prostate cancer who underwent
transrectal associated biopsy in our study. In all patients, gray scale
ultrasonography, color Doppler ultrasonography findings, serum PSA levels,
pathology results were compared and the relationship between them was
investigated.

Results: While moderately differentiated tumors were
more hypoecogenic (69%), poorly differentiated tumors were observed to be mixed
echogenicity (58%). All of the isoecogenic tumors were in the good or moderate
differentiation group. In 11 (17%) of 65 cancer centers, no blood flow was
detected in Doppler US (grade 0). Eight (12%) of 65 patients had first degree
blood flow, while 46 (71%) had second degree blood flow.  It was determined that the PSA values
significantly increased as the degree of vascularization of the lesions
increased. Significant correlations were also found between the Gleason scores
of the tumors and the blood flow grade. All lesions with no evidence of color
Doppler ultrasonography are found in the good or moderately differentiated
cancer group. On the other hand, the majority (98%) of the cancers in which significant
blood flow is detected are found in the moderate or poorly differentiated
group.

Conclusion: There was no additional contribution of color
Doppler ultrasonography to gray scale ultrasonography in detecting prostate
cancer. However, it has been observed that the gray scale ultrasonography
contributes to the manifestation of suspicious lesions. Significant links
between cancer blood levels and Gleason scores were noted. Accordingly, it has
been observed that cancers that show significant blood flow with color Doppler
ultrasonography have higher malignancy than cancers that do not have blood or
minimal blood supply.

Anahtar Kelimeler

Prostate cancer, transrectal ultrasonography, color Doppler ultrasonography, Gleason score

Prostat kanserinin tanısında gri skala ve renkli Doppler ultrasonografinin yeri

Öz

Özet

Amaç: Bu çalışmanın amacı prostat
kanserinde transrektal gri skala ultrasonografi (US) bulguları ile tümörlerin
malignite potansiyelleri arasındaki ilişkiyi incelemek ve transrektal renkli Doppler
ultrasonografinin (RDUS) tanıya olan katkısını araştırmaktır.

Gereç ve Yöntem: Çalışmamızda TRUS eşliğinde
yapılan biyopsi sonrası prostat kanseri saptanan 63 olgu retrospektif olarak
değerlendirilmiştir. Hastaların tümünde gri skala US, RDUS bulguları, serum PSA
düzeyleri, patoloji sonuçları karşılaştırılmış ve aralarındaki ilişki
araştırılmıştır.

Bulgular: Orta diferansiye tümörler daha
çok hipoekojenik iken (%69), kötü diferansiye tümörlerin mikst ekojenitede
oldukları gözlenmiştir (%58). İzoekojenik tümörlerin tümü iyi ya da orta derece
diferansiye grupta yer almışlardır. Toplam 65 kanser odağının 11’inde (%17)
Doppler bakıda kanlanma saptanmazken (derece 0), 8’inde (%12) 1. derece ve
46’sında (%71) 2. derece kanlanma izlenmiştir. Lezyonların kanlanma derecesi
arttıkça PSA değerlerinin belirgin olarak arttığı belirlenmiştir. Tümörlerin
Gleason skorları ile kanlanma dereceleri arasında da önemli bağlantılar tespit
edilmiştir. RDUS ile kanlanma saptanmayan lezyonların tamamı iyi ya da orta
derece diferansiye kanser grubundadır. Buna karşın belirgin kanlanma saptanan
kanserlerin büyük çoğunluğu (%98) orta ya da kötü diferansiye grupta yer
almaktadır.

Sonuç: Prostat kanseri saptanmasında
RDUS’nin gri skala US’ye ilave katkısı bulunmamıştır. Ancak gri skala US ile
kuşkulu lezyonların manifest hale gelmesine katkıda bulunduğu gözlenmiştir.
Kanserlerin kanlanma dereceleri ile Gleason skorları arasında önemli
bağlantılar dikkati çekmiştir. Buna göre RDUS ile belirgin kanlanma gösteren
kanserlerin, kanlanmayan ya da minimal kanlanma izlenen kanserlere göre daha
yüksek maligniteye sahip oldukları gözlenmiştir.

Anahtar Kelimeler

Prostat kanseri, transrektal ultrasonografi, renkli Doppler ultrasonografi

Kaynakça

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