PSAD与双参数前列腺磁共振联合应用 在前列腺癌诊断中的意义

Clinical value of Bi-parametric prostate MR and PSA density in diagnosis of prostate cancer

目的评估前列腺特异性抗原密度(PSAD)、双参数前列腺磁共振单一检测及二者联合在前列腺癌患者中的诊断价值。方法对169例前列腺穿刺的患者进行了回顾性研究(所有患者均于穿刺前行前列腺MRI检查)。通过记录每位患者的PSAD和双参数前列腺磁共振(由T2WI序列及DWI序列组成)结果,进而通过回归曲线和逻辑回归分析,评价PSAD和双参数前列腺磁共振(bp-MR)在前列腺癌早期诊断中的临床应用价值。结果PI-RADS评分在ROC曲线下的面积为(0.890±0.027),PSAD在ROC曲线下的面积为(0.843±0.031),bp-MR与PSAD联合检测在ROC曲线下的面积为(0.932±0.020)。PSAD、PI-RADS评分及二者联合的敏感度分别为67.4%,84.3%,84.3%,特异度分别为90.0%,91.2%,87.5%。结论bp-MR对于前列腺癌的预测效果要显著强于PSAD,,并且PSAD与bp-MR两种检测方法相结合能够显著提高临床上早期前列腺癌的诊断效能。

Objective Prostate specific antigen density(PSAD)and bi parametric magnetic resonance imaging(BPMR)in the detection of early prostate cancer.The purpose of this study is to evaluate the diagnostic value of single detection of PSAD,dual-parameter prostate magnetic resonance or combined detection in patients with prostate cancer.Methods We retrospectively studied 169 patients who prostate biopsy and all underwent prostate MRI before biopsy.We recorded the results of PSAD and two-parameter prostate magnetic resonance imaging(consisting of T2WI and DWI sequences)in each patient were recorded,and then the clinical value of PSAD and two-parameter prostate magnetic resonance imaging(bp-MR)in the early diagnosis of prostate cancer by regression curve and logistic regression analysis were evaluated.Results In all evaluated scenarios,The area under ROC curve for PI-RADS was(0.890±0.027),The area under ROC curve for PI-RADS was(0.843±0.031),The area under ROC curve for their combination was(0.932±0.020).The diagnostic sensitivity of PSAD,PI-RADS and their combination were 67.4%,84.3%,84.3%,the specificity of PSAD、PI-RADS and their combination were 90.0%,91.2%,87.5%.Conclusions The predictive effect of bp-MR for prostate cancer is significantly stronger than that of PSAD,and the combination of PSAD and bp-MR can significantly improve the clinical diagnostic efficiency of early prostate cancer.