摘要
目的探讨前列腺特异抗原密度(PSAD)、中央腺体PSAD(CGPSAD)联合多参数磁共振成像(mpMRI)在前列腺特异抗原(PSA)灰区时(4.0~10.0μg/L)对前列腺癌(PCa)及前列腺增生(BPH)的诊断价值。方法回顾性收集在本院行前列腺穿刺活检的634例患者资料,选取血清PSA处于灰区且进行过mpMRI检查者,共入选121例,分为PCa组和BPH组,应用MRI测量前列腺及中央腺体三径,计算前列腺体积(PV)和中央腺体体积(PVc),比较各组年龄、PSA、PV、PVc、PSAD、CGPSAD、前列腺影像报告和数据系统(PI-RADS)评分,采用多因素Logistic回归寻找PCa的独立危险因素,并绘制其工作特征曲线(ROC),评估其诊断效力。结果两组间总PSA(tPSA)差异无统计学意义,而年龄、PV、PVc、PSAD、CGPSAD及PI-RADS评分的组间差异有统计学意义(P<0.05);多因素Logistic分析显示,PI-RADS评分是PCa的独立危险因素(OR=4.156,P<0.001);ROC曲线分析显示,PSAD、CGPSAD、PI-RADS评分、PSAD联合PI-RADS评分及CGPSAD联合PI-RADS评分的曲线下面积(AUC)值分别为0.744、0.771、0.844、0.884、0.903,CGPSAD联合PI-RADS评分的诊断效能最高。结论在PSA灰区时,CGPSAD诊断PCa的效力优于PSAD,联合mpMRI的PI-RADS评分可明显提高PCa的诊断效能,指导临床和前列腺穿刺活检。
Objective To evaluate the diagnostic value of prostate specific antigen density(PSAD) and central glandular prostate specific antigen density(CGPSAD) combined with multi-parameter magnetic resonance imaging(mpMRI) in the diagnosis of prostate cancer(PCa) and prostate hyperplasia(BPH) in the gray area of prostate specific antigen(PSA)(4.0-10.0 μg/L). Methods Data of 634 patients who had received prostate biopsy in our hospital were retrospectively collected. Among them, 121 patients were selected. According to the pathological results of the biopsy, they were divided into PCa group and BPH group. The three diameters of the prostate and the central gland were measured by MRI. We calculated the prostate volume(PV) and the central gland volume(PVc), and then compared age, PSA, PV, PVc, PSAD, CGPSAD, prostate images, and PI-RADS score between PCa and BPH groups. Multifactor logistic regression analysis was performed to study the independent risk factors for PCa. Receiver operating characteristic(ROC) curves of PCa diagnosis were plotted,respectively, and the area under the curve(AUC) was calculated and compared with the reference. Results There was no significant difference in total prostate specific antigen(tPSA)between the two groups(P >0.05).However,significant differences were observed in age,PV,PVc,PSAD,CGPSAD and PI-RADS score between the two groups(P<0.05).Multifactor logistic regression analysis showed that PI-RADS score was an independent risk factors for PCa(OR =4.156,P<0.001).The AUC value of PSAD,CGPSAD,PI-RADS score,PSAD combined with PI-RADS score and CGPSAD combined with PI-RADS score were 0.744,0.771,0.844,0.884,and 0.903,respectively.The AUC value of CGPSAD combined PI-RADS score was the highest.Conclusion CGPSAD is better than PSAD in diagnosing PCa in the grey area of PSA.Combined with PI-RADS score of mpMRI,it can improve the diagnosis of prostate cancer and guide clinical and prostate biopsy.
作者
杨兰英
唐晓磊
张虎
汪健文
王亚蓉
YANG Lanying;TANG Xiaolei;ZHANG Hu;WANG Jianwen;WANG Yarong(Department of Radiology,Wuhu Second People’s Hospital,Wuhu 241000;Central Laboratory,The Second Affiliated Hospital of Wannan Medical College,Wuhu 241000;Department of Radiology,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2021年第2期285-288,322,共5页
Journal of Xi’an Jiaotong University（Medical Sciences）
基金
青年科学基金资助项目(No.81601806)。
关键词
前列腺癌
前列腺影像报告和数据系统
多参数磁共振成像
前列腺特异性抗原密度
prostate cancer
prostate imaging reporting and data system
multi-parameter magnetic resonance imaging
prostate specific antigen
density
