前列腺中央腺体占总腺体体积比联合前列腺特异抗原在前列腺癌中的诊断价值

Diagnostic value of central prostate gland to total gland volume ratio combined with PSA in prostate cancer

目的探讨前列腺中央腺体占总腺体体积比(PVc/PV)联合前列腺特异抗原(PSA)在前列腺癌中的诊断价值。方法回顾性分析本院2018年4月至2019年3月收治的100例PSA水平在4〜20μg/L且行前列腺穿刺患者的临床资料。通过核磁共振测量前列腺中央腺体及前列腺左右径、上下径及前后径,计算出前列腺中央腺体及前列腺体积,得出PVc/PV。通过穿刺病理检测结果将患者分为前列腺癌组(n=38)及非前列腺癌组(n=62),比较两组患者的游离PSA/总PSA(f/tPSA)、PSA密度(PSAD)、总PSA(f/tPSA)及PVc/PV值差异,并通过受试者工作特征(R0C)曲线分析各指标灵敏度、准确度等。结果本组患者100例,通过病理检查检出前列腺恶性肿瘤38例,活检阳性率为38%。前列腺癌组的f/tPSA、PVc/PV水平低于非前列腺癌组,PSAD水平高于非前列腺癌组,差异均具有统计学意义(P<0.05);tPSA的灵敏度为73.68%,特异度为48.39%;f/tPSA的灵敏度为89.47%,特异度为43.55%;PSAD的灵敏度为78.95%,特异度为62.90%;PVc/PV的灵敏度为84.21%,特异度为75.81%;PVc/PV联合tPSA的灵敏度为84.21%,特异度为87.10%。PVc/PV联合tPSA的R0C曲线下面积(AUC)值最大(0.921),tPSA曲线AUC值为0.731,F/tPSA曲线人AUC值为0.725;PSAD曲线AUC值为0.832;PVc/PV曲线AUC值为0.856。结论PVc/PV联合PSA能作为临床上PSA4〜20μg/L前列腺癌患者诊断的参考指标。

Objective To explore the diagnostic value of central prostate gland to total gland volume ratio(PVc/PV)combined with prostate specific antigen(PSA)in prostate cancer.Methods The clinical data of 100 patients with PSA 4-20μg/L who underwent prostate puncture in our hospital from April 2018 to March 2019 were retrospectively analyzed.The central prostate gland and the lateral diameter,upper and lower diameter and anteroposterior diameter of the prostate were measured by MRI.The volume of the central prostate gland and the prostate were calculated,and PVc/PV was obtained.The patients were divided into prostatic cancer group(n=38)and non-prostatic cancer group(n=62)according to the results of biopsy pathology.The f/tPSA,PSAD,tPSA,and PVc/PV values of the two groups were compared,and through receiver operating characteristic(ROC)curve a-nalysis of each index sensitivity,accuracy,etc.Results In this group of 100 patients,38 cases of prostate cancer were detected by pathological examination,and the positive rate of biopsy was 38%.The levels of f/tPSA and PVc/PV in prostate cancer group were lower than those in non prostate cancer group,and the level of PS AD in prostate cancer group was higher than that in non prostate cancer group(P<0.05).tPSA sensitiv ity 73.68%,specific ity 48.39%.f/tPSA sensitivity 89.47%,specificity 43.55%.PSAD sensitivity 78.95%,specificity 62.90%.PVc/PV sensitivity 84.21%,specificity 75.81%.PVc/PV The combined tPSA has a sensitivity of 84.21%and a specificity of 87.10%.The ROC curve shows that the AUC value of PVc/PV combined with tPSA was the largest,the area under the ROC curve was 0.921,the tPSA curve AUC value was 0.731,the f/tPSA curve AUC value was 0.725.The PSAD curve AUC value was 0.832.The value was 0.856.Conclusions PVc/PV combined with PSA can be used as a reference index for the diagnosis of prostate cancer in patients with PSA 4-20μg/L.