多参数MRI成像技术用于前列腺癌病理和分期的预测价值研究

Predictive value of multiparametric MRI for prostate cancer pathology and tumor staging

目的评价多参数MRI成像技术用于前列腺癌病理和分期的预测价值。方法以2016—2021年收治的80例前列腺癌患者作为研究对象,全部患者均接受多参数MRI成像扫描。以根治性前列腺切除术后病理切片结果作为金标准,评价多参数MRI成像用于显著性前列腺癌、包膜外侵犯、主要病灶部位和淋巴结转移的预测价值。结果多参数MRI用于鉴别显著性前列腺癌的敏感性为96%、特异性为60%、阳性预测值为97.3%、阴性预测值为50%;鉴别主要病变与根治性前列腺切除术后病理切片结果一致性为75%;检测包膜外侵犯敏感性为40%、特异性为91.4%、阳性预测值为85.7%、阴性预测值为54.2%;检测淋巴结转移的准确性为16.7%。结论多参数MRI成像用于鉴别显著性前列腺癌的敏感性和阳性预测值及检测前列腺癌主要病变的准确度均较高,对于制定前列腺癌治疗方案、评估预后等均具有重要价值。

Objective To evaluate the value of multiparametric MRI for prediction of prostate cancer pathology and tumor staging. Methods A total of 80 patients with prostate cancer admitted during the period from 2016 to 2021 were enrolled as the study subjects, and all patients underwent multiparametric MRI. The pathological examination of radical prostatectomy specimens was used as a gold standard to evaluate the predictive value of multiparametric MRI for significant prostate cancaer, extracapsular extension, index lesion location and lymph node metastasis. Results Multiparametric MRI showed a sensitive of 96%, specificity of 60%, positive predictive value of 97.3% and negative predictive value of 50% for prediction of significant prostate cancer, and the concordance between multiparametric MRI and pathology of radical prostatectomy specimens was 75% for prediction of index lesions. In addition, multiparametric MRI showed a 40% sensitivity,91.4% specificity, 85.7% positive predictive value and 54.2% negative predictive value for identification of extracapsular extension and a 16.7% accuracy for detection of lymph node metastasis. Conclusion Multiparametric MRI is highly sensitive for predicting significant prostate cancer with a high positive predictive value and is highly accurate for identification of index lesions of prostate cancer, which is of great value to propose prostate cancer treatment schemes and evaluate the clinical prognosis among prostate cancer patients.