FPSA/TPSA、PSAD联合多参数磁共振成像PI-RADS评分在诊断PSA灰区前列腺癌中的作用

The role of FPSA/TPSA,PSAD combined with multi-parameter magnetic resonance imaging PI-RADS score in the diagnosis of PSA gray area prostate cancer

目的探讨游离前列腺特异性抗原(PSA)与总PSA的比值(FPSA/TPSA)、PSA密度(PSAD)联合多参数磁共振成像(mp-MRI)PI-RADS(前列腺影像数据与报告系统)评分在PSA灰区前列腺癌(PCa)中的诊断价值。方法选取2016年5月至2018年8月在本院就诊的PSA灰区、经前列腺穿刺活检确诊为前列腺癌或良性前列腺增生(BPH)的患者117例,统计上述患者FPSA、TPSA、多参数磁共振PI-RADS评分数据,计算FPSA/TPSA、PSAD,比较两组患者各项指标的差异,并使用受试者工作曲线(ROC)分析FPSA/TPSA、PSAD及多参数磁共振PI-RADS评分对PSA灰区前列腺癌的诊断价值。结果两组患者的年龄、FPSA、TPSA、FPSA/TPSA差异均无统计学意义(P>0.05);但两组患者PSAD、多参数磁共振PI-RADS评分差异有统计学意义(P<0.01);受试者工作曲线(ROC)分析结果显示FPSA/TPSA、PSAD联合PI-RADS评分检测对PCa及BPH患者曲线下面积AUC=0.771(P<0.01)。结论对于PSA在灰区的患者,PSAD、PI-RADS评分对诊断前列腺癌有显著价值。FPSA/TPSA、PSAD联合多参数磁共振成像PI-RADS评分在诊断PSA灰区前列腺癌方面有重要应用价值。

Objective To investigate the diagnostic value of prostate specific antigen free PSA and total PSA ratio,PSA density combined with multiparametric magnetic resonance imaging PI.RADS score in PSA gray area prostate cancer.Methods Patients with prostate cancer or benign prostatic hyperplasia(BPH)diagnosed by prostate biopsy from PSA gray area in the second affiliated hospital of Kunming medical university from May 2016 to August 2018 were selected.The FPSA,TPSA,multi-parameter magnetic and resonance PI-RADS score data were measured.FPSA/TPSA,PSAD were calculated,and the differences between the two groups of patients were compared.The role of FPSA/TPSA,PSAD combined with multi-parameter magnetic resonance imaging PI-RADS score in the diagnosis of PSA gray area prostate cancer was analyzed by receiver operating characteristic(ROC).Results A total of 117 patients were enrolled,including 30 patients in the PCa group and 87 patients in the BPH group.There were no significant differences in age,FPSA,TPSA,FPSA/TPSA between the two groups(P>0.05).However,there were significant differences in PSAD and PI-RADS scores between the two groups(P<0.01).ROC analysis showed that the FPSA/TPSA,PSAD combined with PI-RADS scores for the PCA and BPH patients under the curve AUC=0.771(P<0.01).Conclusions For patients with PSA in the gray zone.PSAD and PI-RADS scores are of significant value in the diagnosis of prostate cancer.FPSA/TPSA,PSAD combined with multi-parameter magnetic resonance imaging PI-RADS score has important application value in the diagnosis of PSA gray area prostate cancer.