血清前列腺特异抗原并超声引导下经直肠前列腺穿刺活检术对前列腺癌的诊断价值

VALUE OF SERUM PROSTATE-SPECIFIC ANTIGEN COMBINED WITH ULTRASOUND-GUIDED TRANSRECTAL PROSTATE BIOPSY IN DIAGNOSIS OF PROSTATE CANCER

目的研究血清前列腺特异抗原(PSA)与超声引导下经直肠前列腺穿刺活检术对前列腺癌的诊断价值。方法回顾性分析2017年12月—2020年3月于我院行超声引导下经直肠前列腺穿刺活检术、前列腺电切术及血清PSA检查的158例可疑前列腺癌患者的临床资料,以前列腺电切术病理检查结果为诊断金标准。分析不同血清PSA水平对于前列腺癌的诊断效能,构建受试者工作特征曲线,分析单独使用血清PSA、超声引导下经直肠前列腺穿刺活检术以及两者联合应用时的诊断价值。结果ROC曲线分析显示,单独使用血清PSA作为诊断标准时,最佳诊断截断值为43μg/L,但诊断灵敏度仅为29%;单独使用超声引导下经直肠前列腺穿刺活检术结果作为诊断标准时,诊断的灵敏度和特异度分别为71%、86%;两者联合应用时诊断灵敏度达100%,诊断特异度达81%,诊断效能较高。结论血清PSA联合超声引导下经直肠前列腺穿刺活检术或可作为诊断前列腺癌的有效手段,以提高前列腺癌的检出率。

Objective To investigate the value of serum prostate-specific antigen(PSA)combined with ultrasound-guided transrectal prostate biopsy in the diagnosis of prostate cancer.Methods A retrospective analysis was performed for the clinical data of 158 patients suspected of prostate cancer who underwent ultrasound-guided transrectal prostate biopsy,electro-prostatectomy,and serum PSA measurement in our hospital from December 2017 to March 2020,with the pathological results of electro-prostatectomy as the gold standard.The efficiency of different serum PSA levels in the diagnosis of prostate cancer was analyzed,and the receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of serum PSA and ultrasound-guided transrectal prostate biopsy used alone or in combination.Results The ROC curve showed that serum PSA alone had an optimal cut-off value of 43μg/L and a sensitivity of 29%;ultrasound-guided transrectal prostate biopsy alone had a sensi-tivity of 71%and a specificity of 86%;the combination of serum PSA and ultrasound-guided transrectal prostate biopsy had a sensitivity of 100%and a specificity of 81%,indicating a high diagnostic efficiency.Conclusion Serum PSA combined with ultrasound-guided transrectal prostate biopsy may be used as an effective method for the diagnosis of prostate cancer to improve the detection rate of prostate cancer.