病理切片对照下国人前列腺癌MRS诊断阈值的可靠性研究  

The Feasibility of CC/C Threshold Value in Diagnosing Prostate Cancer: Compared with Pathologic Findings

作　　者：赵阳[1] 李辛子[1] 韩悦[1] 程紫珺[1] 

机构地区：[1]天津医科大学第二附属医院放射科,300211

出　　处：《临床放射学杂志》2013年第4期595-597,共3页Journal of Clinical Radiology

摘　　要：目的对照前列腺癌(Pca)根治术后病理切片,探讨国人Pca磁共振波谱成像(MRS)的诊断标准及其可靠性。方法根据5例行Pca根治术患者的术前MRS的最大横径层面切取前列腺标本兴趣层,依照MRS兴趣层内诸体素将标本层切块,制备成与MRS结果一一对应的病理切片,分析病理结果中全部有癌区及与之对应区域的MRS的(胆碱+肌酐)/枸橼酸盐(CC/C)值,绘制受试者工作特征曲线获得CC/C诊断Pca的最佳诊断阈值。采用SPSS 11.5分析软件,计算本组数据在CC/C值>0.86标准下诊断Pca的敏感性、特异性及准确性,再采用受试者工作特征曲线分析法选择本研究数据诊断Pca最佳CC/C值,并计算在此标准下的敏感性、特异性及准确性。结果本实验共得病理结果 90个,无癌区20个,有癌区70个,得到CC/C值90个,在CC/C值>0.86标准下,MRS诊断无癌区25个,有癌区65个,与病理对照诊断正确区域分别为14个和59个,MRS诊断Pca的准确性为CA=81.1%,敏感性为Se=84.3%、特异性为Sp=70.0%。利用受试者工作特征曲线确定基于本研究CC/C值的诊断阈值(Cut-off值)以0.88最佳,以此标准计算MRS诊断Pca的准确性为CA=80.0%,敏感性为Se=81.4%,特异性为Sp=75.0%。结论 CC/C值>0.88较国际标准的>0.86可能更适合于国人的Pca MRS诊断。Objective To explore the MRS threshold value and its feasibility in the diagnosis prostate cancer compared with postoperative pathological results. Methods Five patients with prostate cancer underwent MRS scan and radical prostatectomy. The prostate sections were made corresponding to MRS voxels. MRS CC/C values of voxels in cancer were analyzed and compared with pathological findings. ROC curve was depicted to find the optical threshold value. Results There were 90 regions, included 70 regions with cancer and 20 regions without cancer confirmed by pathological results. According to CC/C value above 0.86, 65 regions with cancer and 25 regions without cancer were detected by MRS. Among them, 59 regions with cancer and 14 regions without cancer were correct compared with pathological findings. The accuracy,sensitivity, specificity of MRS diagnosis at cc/c value of 0. 86 were 81.1%, 84.3% and 70.0%. The accuracy, the sensitivity and the specificity of MRS diagnosis at cc/c value of O. 88 were 80.0%, 81.4% and 75%. It is confirmed that the CC/C value of 0.88 was the optical threshold in the diagnosis prostate cancer by ROC curve. Conclusion The MRS threshold value, CC/C value of O. 88, is more appropriate for Chinese in the diagnosis of prostate cancer.

关 键 词：前列腺肿瘤 磁共振成像 磁共振波谱成像 病理学 

分 类 号：R737.25[医药卫生—肿瘤]