多模态磁共振联合血清PSA相关参数在前列腺癌诊断中的应用价值

Application value of multimodal magnetic resonance combined with serum PSA related parameters in the diagnosis of prostate cancer

目的探讨多模态MRI前列腺影像报告和数据系统(PI-RADS)评分联合前列腺特异性抗原(PSA)相关参数在前列腺癌(PCa)诊断中的价值。方法回顾性分析在影像科进行前列腺MRI检测的167例患者临床及影像资料,根据病理结果分为PCa组和良性前列腺病变组。比较两组的年龄、PI-RADS评分、前列腺特异性抗原密度(PSAD)、总前列腺特异抗原(tPSA)、游离前列腺特异抗原/总前列腺特异抗原(f PSA/tPSA);构建受试者工作特征(ROC)曲线,分析PI-RADS评分、PSAD及tPSA单独及联合检测对PCa的诊断效能。结果病理结果显示PCa 95例,良性前列腺病变72例。PCa组的PI-RADS评分、PSAD及tPSA高于良性前列腺病变组,差异具有统计学意义(P<0.05)。ROC曲线结果显示,PI-RADS评分对PCa的诊断效能较好;PI-RADS评分+tPSA+PSAD对PCa的诊断效能最好,但与PI-RADS评分+PSAD比较,差异无统计学意义(P>0.05)。结论PI-RADS评分联合PSAD、tPSA可进一步提高诊断效能,为PCa的诊断及穿刺提供更好的依据。

Objective To explore the value of multimodal MRI Prostate Imaging Reporting and Data System(PI-RADS)score combined with prostate-specific antigen(PSA)related parameters in the diagnosis of prostate cancer(PCa).Methods The clinical and imaging data of 167 patients who underwent prostate MRI in the imaging department were retrospectively analyzed.According to the pathological results,the patients were divided into PCa group and benign prostatic lesion group.The age,PI-RADS score,prostate-specific antigen density(PSAD),total prostate specific antigen(tPSA),free prostate specific antigen/total prostate specific antigen(fPSA/tPSA)were compared between the two groups;the receiver operating characteristic(ROC)curve was constructed to analyze the diagnostic efficacy of PI-RADS score,PSAD and tPSA alone and in combination for PCa.Results Pathological results showed 95 cases of PCa and 72 cases of benign prostatic lesions.The PI-RADS score,PSAD and tPSA in the PCa group were higher than those in the benign prostatic lesion group,and the differences were statistically significant(P<0.05).ROC curve results showed that PI-RADS score had better diagnostic efficacy for PCa;PI-RADS score+tPSA+PSAD had the best diagnostic efficacy for PCa,but there was no significant difference compared with PI-RADS score+PSAD(P>0.05).Conclusion PI-RADS score combined with PSAD and tPSA can further improve the diagnostic efficiency and provide a better basis for the diagnosis and puncture of PCa.