多参数磁共振对前列腺癌的诊断价值及其与Gleason分级评分的相关性研究

Study on the diagnostic value of magnetic resonance with multi-parameter for prostate cancer and the correlation of that with Gleason score

目的:探索多参数磁共振成像(mp-MRI)应用前列腺成像报告和数据系统第2版(PI-RADS v2.1)对前列腺癌(PCa)的诊断价值及其与PCa Gleason分级评分的相关性。方法:选取在医院行mp-MRI且经穿刺病理证实的120例前列腺疾病患者,其中PCa患者68例,前列腺增生患者52例。以组织病理学检查结果为“金标准”,采用PI-RADS v2.1在双盲法下进行评分,使用受试者工作特征(ROC)曲线分析其PCa的诊断效能,采用Spearson相关性分析PI-RADS v2.1与PCa Gleason分级评分的相关性。结果:PI-RADS v2.1诊断PCa的ROC曲线下面积(AUC)为0.957,最佳截断值≥3分,灵敏度95.1%,特异度79.3%,准确率88.3%,阳性预测值85.5%,阴性预测值93.2%。PI-RADS v2.1与PCa Gleason分级评分呈高度正相关(r=8.08,P<0.01)。结论:mp-MRI应用PI-RADS v2.1与PCa Gleason分级评分具有高度相关性,且对前列腺病变具有较高的的诊断效能。

Objective:To explore the diagnostic value of multi-parameter magnetic resonance imaging(mp-MRI)for prostate cancer(PCa)by using Prostate Imaging Reporting and Data System version 2.1(PI-RADS v2.1)and the correlation of that with PCa Gleason grading score.Methods:A total of 120 patients with prostate diseases who underwent mp-MRI and were confirmed by puncture pathology in hospital were selected.The 68 patients of them were confirmed as prostate cancer and other 52 patients were confirmed as prostatic hyperplasia.The histopathological result was used as the gold standard,and PI-RADS v2.1 was adopted to conduct score under a double-blind method.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of that for PCa,and Spearson correlation analysis was used to analyze the correlation between PI-RADS v2.1 and PCa Gleason grading score.Results:The area under the curve(AUC)of PI-RADS v2.1 in diagnosing the prostate cancer was 0.957,and the best cutoff value of that was≥3 scores,and the sensitivity,the specificity,the accuracy,the positive predictive value and the negative predictive value of that respectively were 95.1%,79.3%,88.3%,85.5%and 93.2%.In addition,PI-RADS v2.1 was highly correlated with PCa Gleason grading score(r=8.08,P<0.01).Conclusion:The application of PI-RADS v2.1 in mp-MRI has a high correlation with PCa Gleason grading score,which has higher diagnostic efficiency for prostate lesions.