PCA3联合mMRI在前列腺癌诊断中的意义

The significance of PCA3 combining with mMRI in detecting of prostate cancer

目的探讨前列腺癌基因3(prostate cancer gene 3,PCA3)和多参数磁共振成像(multiparametric magnetic resonance imaging,mMRI)对前列腺癌的诊断意义。方法对56例首次穿刺结果为阴性但PSA持续升高的患者在第二次穿刺活检之前行PCA3和mMRI检查。评估PCA3评分和mMRI对前列腺癌诊断的准确性和可靠度及其对前列腺穿刺结果的预测性。结果 mMRI结果显示20例(35.7%)患者具有前列腺癌特征;PCA3评分(截断值为35时)显示15例(26.8%)患者疑为前列腺癌;前列腺穿刺活检结果显示23例(41.1%)患者确诊为前列腺癌。PCA3和mMRI对前列腺癌诊断的敏感性和特异性分别为67%、49%及74%、89%。结论 mMRI增加了PCA3对前列腺癌诊断的准确性和敏感性,可以减少不必要的前列腺穿刺。

Objective To evaluate the value of the urinary prostate cancer gene 3（PCA3）assay combining multiparametric magnetic resonance imaging（mMRI）in diagnosis of prostate cancer（PCa）. Methods A study of 56 patients with a longlasting high prostate-specific antigen level and previously negative biopsy was performed to assess the role of mMRI and PCA3 in identifying PCa,the accuracy and reliability were evaluated. Results mMRI showed that 20（35.7%）patients were may sufferer PCa;And PCA3 scores showed that 15（26.8%）cases may suffer from PCa;Repeated transrectal ultrasound（TRUS）-guided biopsy identified 23（41.1%）new cases of PCa.The sensitivity and specificity of PCA3 test and mMRI was 67%and 49%and 74%and 89%,respectively.The study showed that the model included mMRI and PCA3 had a better performance in predicting PCa. Conclusions mMRI can improve the accuracy and sensitivity of PCA3 for diagnosis of PCa,therefore,can avoid unnecessary biopsies.