摘要
目的应用判别分析探讨不同指标对前列腺癌预测诊断中的应用价值。方法收集2008年1月-2011年9月经直肠超声检查并行经直肠超声引导下经会阴前列腺穿刺活检术,具有前列腺特异性抗原(PSA)、超声图像特征的941例患者以及其中含有血流阻力指数(RI)指标的200例患者的临床资料,采用最近距离及极大似然判别分析两种方法分别拟合患者年龄、血清PSA、经直肠前列腺超声声像图特征以及RI指标预测前列腺癌。结果最近距离判别分析显示RI对前列腺癌的判别无临床意义。联合患者年龄、超声检查和血清PSA值,判别结果提示超声、超声+年龄、年龄+超声+PSA三种判别的灵敏度逐渐增加。年龄+超声+PSA联合指标的灵敏度为88.89%,其错判率在20.00%以内。结论年龄+超声+PSA联合指标的极大似然判别分析可提高前列腺癌的诊断预测水平,避免前列腺穿刺给患者带来的痛苦,并给临床医生的临床诊断提供参考,有较好的应用价值。
Objective To explore the diagnostic value of different indicators for prostate cancer by discriminant analysis. Methods A total of 941 patients with PSA and ultrasound image features, including 200 with blood flow resistance index, underwent transrectal ultrasonography combined with transrectal ultrasound-guided perineal prostate biopsy between January 2008 and September 2011. We used K-nearset neighbor （KNN） method and maximum likelihood discriminant to fit model with such indexes as patients＇ age, serum PSA, sonographic characteristics and resistance index to predict prostate cancer. Results KNN discriminant analysis showed that resistance index had no clinically significance in predicting prostate cancer. The analysis results with consideration of patients＇ age, ultrasound examination and serum PSA values suggested that the sensitivity of three kinds of discrimination including ultrasound, ultrasound ＋ age, age ＋ ultrasound ~ serum PSA increased gradually. The sensitivity of joint indicators of age ＋ ultrasound ＋ serum PSA was 88.89% with misjudging rate of less than 20%. Conclusion The joint indicators of age ＋ ultrasound ＋ PSA using maximum likelihood discriminant analysis can improve the forecast level of prostate cancer diagnosis, can avoid prostate biopsy pain and provide a reference to the clinicians＇ clinical diagnosis.
出处
《华西医学》
CAS
2013年第4期563-566,共4页
West China Medical Journal
