磁共振成像与前列腺癌诊断以及肿瘤恶性程度的相关性分析

Correlation of MRI image with the diagnosis of prostate cancer and tumor malignancy grade

目的评估磁共振成像（MRI）影像结果与前列腺癌检出率及肿瘤恶性程度的相关性。方法回顾性分析北京医院泌尿外科前列腺特异性抗原（PSA）20μg／L以下患者前列腺穿刺活检资料，比较MRI结果与肿瘤检出率、Gleason评分以及肿瘤转移的相关性。结果本组218例患者，经穿刺活检诊断前列腺癌88例（40．4％）。MRI阳性患者126例，穿刺阳性结果73例（57．9％）；MRI阴性患者92例，穿刺阳性结果15例（16．3％）。MRI对于前列腺癌诊断的敏感性82．95％，特异性58．78％，阳性预测值57．94％，阴性预测值83．70％。MRI对于前列腺癌诊断的受试者工作特征（ROC）曲线下面积为0．709。MRI结果与Gleason评分有相关性。结论在PSA20μg／L以下的患者中，MRI影像结果与前列腺癌检出率、肿瘤Gleason评分相关。

Objective To evaluate the correlation of MRI image with the detection rate of prostate cancer and cancer malignancy grade. Methods The prostate biopsy data of patients with prostate specific antigen （PSA） less than 20 μg/L were retrospectively analyzed. The correlations of MRI results with the cancer detection rate, Gleason score and tumor metastasis were analyzed and compared. Results Of 218 cases, 88 prostate cancer patients （40.4%） were detected out by prostate puncture biopsy. In 126 MRI-positive prostate cancer patients, the detection rate of prostate cancer by prostate puncture biopsy was 57.9% （73 cases）. In 92 MRI-negative prostate cancer patients,the detection rate of prostate cancer by prostate puncture biopsy was 16.3% （15 cases）. The sensitivity, specificity, positive prognostic rate and negative prognostic rate by MRI were 82.95%, 58.78%, 57.94% and 83.70%, respectively. The area under receiver operating characteristic （ROC） curve for MRI to predict prostate cancer was 0. 709. MRI results had a correlation with Gleason score. Conclusions MRI image has significant correlation with prostate cancer detection rate and Gleason score in patients with PSA less than 20μg/L.