MRI与经直肠超声引导下前列腺穿刺活检术对不同PSA水平前列腺癌患者的诊断效能比较

Comparitive study on the diagnostic efficiency of MRI and transrectal ultrasound-guided prostate biopsy in diagnosis of prostate cancer in patients with different levels of PSA

目的探讨不同水平前列腺特异性抗原(PSA)患者核磁共振成像(MRI)与经直肠超声引导下前列腺穿刺活检术对前列腺癌的诊断效能。方法前瞻选取2018年9月至2020年6月医院接受前列腺指诊、PSA检测、超声或电子计算机断层扫描(CT)影像检查后高度疑似前列腺癌的90例患者作为研究对象,按照不同PSA水平分组,分别接受前列腺MRI检查和经直肠超声引导下前列腺穿刺活检术,并以活检结果作为金标准,观察不同水平下MRI对前列腺癌的诊断价值。结果90例高度疑似前列腺癌患者,经穿刺病理活检结果显示,确诊为前列腺癌34例,检出率37.78%;前列腺癌患者平均PSA水平高于良性病变患者,差异有统计学意义(P<0.05);相较于4 ng/ml<PSA水平<10 ng/ml、10 ng/ml≤PSA水平<30 ng/ml联合MRI检查,PSA水平≥30 ng/ml联合MRI检查与金标准一致性高,且诊断前列腺癌的敏感度、阳性预测值高,差异有统计学意义(P<0.05)。结论PSA水平越高,联合MRI检查与经直肠超声引导下前列腺穿刺活检术的一致性越高,诊断准确性越高,敏感度越好。

Objective To investigate the diagnostic efficiency of MRI and transrectal ultrasound-guided prostate biopsy in diagnosis of prostate cancer in patients with different levels of PSA.Methods A total of 90 patients with highly suspected prostate cancer who underwent digital prostate examination,PSA test,ultrasound or computer tomography(CT)imaging examination in our hospital from September 2018 to June 2020 were enrolled in the study,who were divided in to groups according to PSA levels,then who underwent prostate MRI examination and transrectal ultrasound-guided prostate biopsy,respectively.Taking the biopsy results as gold standard,the diagnostic value of MRI in diagnosis of prostate cancer was analyzed.Results Of the 90 patients,the percutaneous biopsy results showed that 34 patients were diagnosed as prostate cancer,with the detection rate being 37.78%.The average PSA levels in patients with prostate cancer were significantly higher than those of patients with benign lesions(P<0.05).As compared with 4ng/ml<PSA level<10ng/ml and 10ng/ml≤PSA level<30ng/ml combined with MRI examination,the PSA level≥30ng/ml combined with MRI examination had higher consistency with the gold standard,and its sensitivity and positive predictive value in diagnosis of prostate cancer were higher(P<0.05).Conclusion The higher the PSA level,the higher the consistency of MRI examination and transrectal ultrasound-guided prostate biopsy,the higher the diagnostic accuracy and sensitivity.