T2WI和DWI联合血清前列腺特异抗原系列诊断前列腺癌  

T2WI and DWI combined with serum prostate specific antigen series in diagnosis of prostate cancer

作　　者：李鹏[1] 杨文君[2] 陈志强[3] 郭玉林[3] 蔡磊[3] 杨文静[1] 李燕[1] 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏医科大学基础医学院,宁夏银川750004 [3]宁夏医科大学总医院放射科,宁夏银川750004

出　　处：《中国医学影像技术》2013年第4期612-616,共5页Chinese Journal of Medical Imaging Technology

基　　金：宁夏自然科学基金资助项目(NZ09110);宁夏自然科学基金资助项目(NZ1234)

摘　　要：目的探讨T2WI+DWI联合血清前列腺特异抗原(PSA)系列对前列腺癌(PCa)的诊断价值。方法回顾性分析经病理证实的50例PCa(阳性组)、50例前列腺增生(BPH)和10例BPH合并慢性前列腺炎(CP)患者(阴性组)的MRI、DWI资料和总PSA(tPSA)、游离PSA(fPSA)与tPSA的比值(f/tPSA)、前列腺特异抗原密度(PSAD)检测结果,比较T2WI+DWI及T2WI+DWI分别联合tPSA、f/tPSA、PSAD诊断PCa的敏感度、特异度和准确率,通过ROC曲线下面积(AUC)值比较每种方法的诊断效能。结果阳性组和阴性组间tPSA、f/tPSA、PSAD差异均有统计学意义(t=10.10、-4.52、14.41,P均<0.01);T2WI+DWI诊断PCa的敏感度、特异度、准确率和AUC分别为92.00%、71.67%、80.91%和0.818,95%可信区间为0.752～0.885;以tPSA>10ng/ml、f/tPSA≤0.15、PSAD≥0.22ng/(ml.cm3)为诊断PCa的界值,T2WI+DWI分别联合tPSA、f/tPSA、PSAD诊断PCa的特异度、准确率和AUC均明显提高。T2WI+DWI联合PSAD诊断PCa的效能最好,其敏感度、特异度、准确率和AUC分别为88.00%、90.00%、89.09%和0.890,95%可信区间为0.829～0.951。结论T2WI+DWI联合tPSA、f/tPSA、PSAD能够明显提高对PCa的诊断效能。Objective To investigate the value of T2WI＋DWI combined with serum prostate specific antigen （PSA） se- ries in diagnosis of prostate cancer （PCa）. Methods Fifty patients with PCa （positive group）, 50 with benign prostate hy- perplasia （BPH） and 10 with BPH and chronic prostatitis （negative group） proved by pathology who underwent conven- tional MRI, DWI examination were enrolled, and all of them had PSA data （including total PSA [tPSA], ratio of free PSA to tPSA [f/tPSA], PSA density PSAD]） . The diagnostic sensitivity, specificity and accuracy of T2WI-i-DWI and T2WI ＋DWI combined with tPSA, f/tPSA, PSAD were compared. The area under ROC curve （AUC） of each method was eval- uated, Results The mean value of tPSA, {/tPSA, PSAD in the two groups were statistically different （t=10.10,-4. 52, 14.41, all P〈0.01）. The sensitivity, specificity, accuracy and AUC of T2WI＋DWI was 92.00%, 71.67Y;, 80. 91~ and 0. 818, respectively, and 95% confidence interval was 0. 752--0. 885. Taking tPSA^10 ng/ml, f/tPSA^0.15, PSAD~ 0.22 ng/（ml ~ cma） as diagnosis standards of PCa, the specificity, accuracy and AUC of combination of T2WI＋DWI and tPSA, f/tPSA, PSAD respectively were all significantly improved. The diagnostic value of T2WI＋DWI＋ PSAD was the best, the sensitivity, specificity, accuracy and AUC was 88.00%, 90.00%, 89.09% and 0. 890, 95% confidence interval was 0. 829--0. 951. Conclusion T2WI＋DWI combined with tPSA, f/tPSA, PSAD respectively can improve the diagnosis accuracy of PCa.

关 键 词：前列腺肿瘤 前列腺增生 前列腺特异抗原 磁共振成像 扩散磁共振成像 

分 类 号：R737.25[医药卫生—肿瘤] R445.2[医药卫生—临床医学]