Likert量表联合PSA相关指标预测前列腺癌包膜外侵犯的准确性

Accuracy of likert scale combined with PSA-related indicators in predicting extracapsular extension of prostate cancer

目的探讨基于多参数MRI Likert量表联合前列腺特异抗原(PSA)相关指标预测前列腺癌(PCa)包膜外侵犯的准确性。方法选取本院行根治性PCa术151例患者的临床资料。通过单因素分析比较PCa包膜外侵犯阳性与阴性患者检测指标之间的差异;通过多因素logistic回归分析筛选PCa包膜外侵犯的独立危险因素,绘制独立危险因素的受试者工作特征曲线(ROC),并计算曲线下面积(AUC),分析其诊断效能。结果PCa有包膜外侵犯阳性28例,无包膜外侵犯阴性123例。单因素分析结果显示PCa包膜外侵犯阳性患者的总前列腺特异抗原(tPSA)、血清游离前列腺特异抗原(fPSA)、前列腺特异抗原密度(PSAD)、Likert量表分级均高于阴性患者,差异均有统计学意义(P<0.05)。多因素logistic分析结果显示Likert量表分级和PSAD是PCa包膜外侵犯的独立危险因素。ROC曲线分析显示,Likert量表≥3级、PSAD>0.33 ng/ml2为预测PCa包膜外侵犯的最佳阈值,Likert量表联合PSAD预测PCa包膜外侵犯的准确性优于单纯Likert量表(P<0.05),Likert量表分级≥3级且PSAD>0.33 ng/ml2预测PCa包膜外侵犯阳性率相对较高为72.7%(16/22),而Likert分级≤2级且PSAD≤0.33 ng/ml2预测PCa包膜外侵犯的阳性率较低,为6.2%(3/48)。结论基于多参数MRI Likert量表分级联合PSAD对PCa包膜外侵犯有重要的预测意义,Likert量表分级≥3级且PSAD>0.33 ng/ml2对PCa包膜外侵犯具有较高的预测准确性。

Objective Based on multi-parameter magnetic resonance imaging,to explore the accuracy of Likert scale combined with PSA related indicators in predicting extracapsular extension of prostate cancer.Methods The clinical data of 151 patients undergoing radical prostate cancer surgery in our hospital were selected.The differences in the above indicators between positive and negative patients with extracapsular extension of prostate cancer were compared by univariate analysis.The independent risk factors of extracapsular extension of prostate cancer were screened by multivariate logistic regression analysis.The receiver operating characteristic curve of the independent risk factors was drawn,and the area under the curve was calculated to analyze its diagnostic efficacy.Results In this study,there were 28 cases of prostate cancer with extracapsular extension,and 123 cases of prostate cancer without extracapsular extension.The results of univariate analysis showed that the tPSA,fPSA,PSAD,and Likert scale grading of positive patients with extracapsular extension of prostate cancer were higher than those of negative patients,and the differences were statistically significant(P<0.05).The results of multivariate logistic analysis showed that the Likert scale grading and PSAD were independent risk factors for extracapsular extension of prostate cancer.ROC curve analysis showed that Likert scale≥3 and PSAD>0.33 ng/ml2 were the optimal thresholds for the prediction of extracapsular extension of prostate cancer.The accuracy of Likert scale combined with PSAD in predicting extracapsular extension of prostate cancer was better than that of Likert scale alone(P<0.05).Likert scale grading≥3 and PSAD>0.33 ng/ml2 in the prediction of extracapsular extension of prostate cancer had a relatively high positive rate of 72.7%(16/22).The positive rate of extracapsular extension of prostate cancer with Likert grade≤2 and PSAD≤0.33 ng/ml2 was 6.2%(3/48).Conclusion Likert scale grading combined with PSAD has important predictive significance for extracapsular extension of prostate cancer based on multiparameter magnetic resonance.Likert scale grade≥3 and PSAD>0.33 ng/ml2 have a high predictive accuracy for extracapsular extension of prostate cancer.