基于PI-RADS V2的MRI参数联合PSAD对前列腺恶性病变的鉴别诊断价值分析

Value of PI-RADS V2 based MRI parameters combined with PSAD in the differential diagnosis of prostate diseases

目的:探究基于第2版前列腺影像报告和数据系统(PI-RADS V2)的核磁共振(MRI)参数联合前列腺特异性抗原密度(PSAD)对前列腺病变的鉴别诊断价值。方法:回顾性分析2018年5月~2019年12月于本院就诊治疗的130例前列腺病变患者的临床资料,根据其病理检查结果分类,其中前列腺癌患者75例,为恶性组;良性病变患者55例,为良性组,比较两组PI-RADS V2的MRI参数和血清总前列腺特异性抗原(tPSA)等差异,并分析PI-RADS V2评分与PSAD对前列腺病变鉴别的诊断价值。结果:恶性组血清tPSA水平、PI-RADS V2评分及PSAD值均明显高于良性组(P<0.05);经ROC曲线分析,PSAD(AUG=0.841,95%CI为0.772~0.909,P<0.05)、PI-RADS V2评分(AUG=0.893,95%CI为0.833~0.953,P<0.05)对于鉴别良恶性前列腺均具有一定诊断价值,其特异度分别为90.64%、83.60%,灵敏度为65.30%、77.65%,二者联合诊断诊断价值更高(AUG=0.950,95%CI为0.913~0.987,P<0.05),其特异度为80.00%,灵敏度为88.00%。结论:PCa患者与良性前列腺病变患者的血清tPSA水平、PI-RADS V2评分及PSAD值存在显著差异,PI-RADS V2评分、PSAD具有较高的良恶性前列腺病变诊断鉴别价值,二者并联检测诊断效能更高。

Objective:To explore the value of MRI parameters based on Prostate Imaging Reporting and Data System Version 2(PI-RADS V2)combined with prostate specific antigen density(PSAD)in the differential diagnosis of prostate diseases.Methods:The clinical data of 130 patients with prostate disease treated in the hospital from May 2018 to December 2019 were retrospectively analyzed.According to pathological examination results,there were 75 cases with prostate cancer(PCa)(malignant group)and 55 cases with benign lesions(benign group).The differences in MRI parameters of PI-RADS V2 and serum total prostate specific antigen(tPSA)were compared between the two groups.The value of PI-RADS V2 scores and PSAD in the differential diagnosis of prostate diseases was analyzed.Results:The level of serum tPSA,PI-RADS V2 score and PSAD in malignant group were significantly higher than those in benign group(P<0.05).ROC curve analysis showed that both PSAD(AUG=0.841,95%CI:0.772-0.909,P<0.05)and PI-RADS V2 score(AUG=0.893,95%CI:0.833-0.953,P<0.05)were of certain value in distinguishing benign from malignant prostate diseases.Their specificity and sensitivity were(90.64%,83.60%)and(65.30%.77.65%),respectively.The diagnosis value of PSAD combined with PI-RADS V2 score was higher(AUG=0.950,95%CI:0.913-0.987,P<0.05),and its specificity and sensitivity were 80.00%and 88.00%,respectively.Conclusion:There are significant differences in level of serum tPSA,PI-RADS V2 score and PSAD between PCa patients and patients with benign prostate diseases.The value of both PI-RADS V2 score and PSAD is high in the differential diagnosis of benign and malignant prostate diseases.The diagnostic efficiency of their combination is higher.