磁共振成像联合血清microRNA-221对前列腺癌的诊断价值

Value of magnetic resonance imaging combined with serum microRNA-221 detection in the diagnosis of prostate cancer

目的探讨磁共振成像(MRI)结合血清microRNA-221-221(miR-221)检测在前列腺癌诊断中的价值。方法回顾性分析2019年5月—2023年1月襄阳市中心医院收治的103例疑似前列腺癌患者的临床资料,将前列腺穿刺病理结果作为金标准。所有患者行磁共振弥散加权成像(MRI-DWI)、动态增强磁共振成像(MRI-DCE)及血清miR-221检测,分析MRI参数、miR-221诊断前列腺癌的价值。结果穿刺活检病理诊断结果显示,103例前列腺癌疑似患者中,73例诊断为前列腺癌。前列腺癌患者表现弥散系数(ADC)值低于非前列腺癌患者(P<0.05)。前列腺癌患者容积转运常数(K_(trans))高于非前列腺癌患者(P<0.05),前列腺癌与非前列腺癌患者的速率常数(K_(ep))、细胞外间隙对比剂容积分数(V_(e))比较,差异均无统计学意义(P>0.05)。前列腺癌患者miR-221相对表达量高于非前列腺癌患者(P<0.05)。ROC曲线分析结果显示,ADC、K_(trans)、miR-221及3者联合诊断前列腺癌的敏感性分别为72.60%(95%CI:0.607,0.821)、69.86%(95%CI:0.578,0.798)、73.97%(95%CI:0.622,0.832)、82.19%(95%CI:0.711,0.898),特异性分别为80.00%(95%CI:0.609,0.916)、73.33%(95%CI:0.538,0.870)、70.00%(95%CI:0.504,0.846)、86.67%(95%CI:0.684,0.956),AUC分别为0.756(95%CI:0.651,0.860)、0.741(95%CI:0.633,0.848)、0.739(95%CI:0.631,0.846)、0.907(95%CI:0.842,0.972)。结论ADC、K_(trans)、miR-221联合诊断前列腺癌效能较高,3者联合诊断前列腺癌可提供更加精确可靠的量化参数。

Objective To investigate the value of magnetic resonance imaging(MRI)combined with serum microRNA-221-221(miR-221)detection in the diagnosis of prostate cancer.Methods The clinical data of 103 patients with suspected prostate cancer admitted to the hospital from May 2019 to January 2023 were retrospectively analyzed,and the pathological results of prostate biopsy were set as the gold standard.All patients underwent magnetic resonance diffusion-weighted imaging(MRI-DWI),dynamic contrast-enhanced magnetic resonance imaging(MRI-DCE)and serum miR-221 detection.The value of MRI parameters and the relative expression of miR-221 in the diagnosis of prostate cancer was analyzed.Results The pathological results of prostate biopsy showed that 73 of 103 patients with suspected prostate cancer were finally diagnosed with prostate cancer. The apparent diffusion coefficient (ADC) of patients with prostate cancer was lower than that of patients without prostate cancer (P < 0.05). The volume transfer constant (K_(trans)) of patients with prostate cancer was higher than that of patients without prostate cancer (P < 0.05). There were no significant differences in the rate constant (K_(ep)) and extracellular volume fraction (V_(e)) between patients with and without prostate cancer (P > 0.05). The relative expression of miR 221 in patients with prostate cancer was higher than that in patients without prostate cancer (P < 0.05). Receiver operating characteristic (ROC) curve analysis exhibited that sensitivities of ADC, K_(trans), miR-221 and their combination for diagnosing prostate cancer were 72.60% (95% CI: 0.607, 0.821), 69.86% (95% CI: 0.578, 0.798), 73.97% (95% CI: 0.622, 0.832), and 82.19% (95% CI: 0.711, 0.898), with the specificities being 80.00% (95% CI: 0.609, 0.916), 73.33% (95% CI: 0.538, 0.870), 70.00% (95% CI: 0.504, 0.846), and 86.67% (95% CI: 0.684, 0.956), and the areas under ROC curves (AUCs) being 0.756 (95% CI: 0.651, 0.860), 0.741 (95% CI: 0.633, 0.848), 0.739 (95% CI: 0.631, 0.846), and 0.907 (95% CI: 0.842, 0.972). Conclusions The combination of ADC, K_(trans), and miR 221 displays high predictive efficacy in the diagnosis of prostate cancer, and their combination may provide more accurate and reliable quantitative parameters for diagnosing prostate cancer.