磁共振波谱成像联合fPSA/tPSA、PSAD对PSA灰区前列腺癌的诊断价值  

Value of MRS combined with fPSA/tPSA and PSAD in diagnosing prostate cancers at PSA gray zone

作　　者：舒泽华[1] 张克勤[1] 王毅[2] 

机构地区：[1]第三军医大学大坪医院野战外科研究所泌尿外科,重庆400042 [2]第三军医大学大坪医院野战外科研究所放射科,重庆400042

出　　处：《重庆医学》2015年第13期1768-1770,共3页Chongqing medicine

摘　　要：目的 探讨磁共振波谱成像（MRS）联合前列腺特异性抗原（PSA）比值（fPSA/tPSA）及PSA密度（PSAD）在PSA灰区（4~10ng/mL）对前列腺癌（PCa）的诊断价值。方法 选取PSA位于灰区,病理检查证实为前列腺增生（BPH）或PCa的男性患者60例,收集tPSA、fPSA数据,计算PSAD、fPSA/tPSA、（胆碱＋肌酸）/枸橼酸盐的数值,用受试者工作特征（ROC）曲线分析MRS联合PSAD及fPSA/tPSA对PCa的诊断价值。结果 PCa组（n=24）和BPH组（n=36）的年龄和tPSA差异无统计学意义（P〉0.05）;fPSA、fPSA/tPSA、前列腺体积、PSAD和MRS的差异均有统计学意义（P〈0.05）;MRS、PSAD和fPSA/tPSA诊断PCa的效果相似（P〉0.05）;MRS与PSAD或fPSA/tPSA联合后对PCa诊断效能无明显增加（P〉0.05）;MRS、PSAD和fPSA/tPSA三者联合后,诊断效能显著增加（P〈0.05）。结论 MRS联合PSAD及fPSA/tPSA可提高灰区PCa诊断的准确性,对灰区PCa诊断有较高应用价值。Objective To explore the value of magnetic resonance spectroscopy （MRS） combined with floating prostatic specific antigen（fPSA）/total prostatic specific antigen（tPSA） and PSA density（PSAD） in diagnosing prostate cancer at serum PSA gray zone （4-10 ng/mL）. Methods Sixty male patients with pathologically comfirmed benign prostatic hyperplasia （BPH） or prostate cancer （PCa）, and serum PSA at 4-10 ng/mL were studied. The data of tPSA and fPSA were collected, PSAD, fPSA/tP- SA and（choline ＋ creatine / citrate）were calculated. The diagnostic performances of MRS,PSAD, fPSA/tPSA and their combined performance were analyzed with receiver operating characteristic （ROC） curve. Results Age and tPSA showed no statistically significant differences between the BPH group（n= 36） and the PCa group（n= 24） （P〉0.05）;fPSA, fPSA/tPSA, prostate volume, PSAD and MRS all displayed statistically significant differences between the two groups （P〈0.05） ;MRS,PSAD and fPSA/tPSA had the similar effect for diagnosing PCa （P〉0.05） ;MRS combined with PSAD or fPSA/tPSA had no significant increase in the diagnostic efficacy of prostate cancer （P〉0.05） ;however,MRS combined with PSAD and fPSA/tPSA showed significant increase in the diagnostic efficacy （P〈0.05）. Conclusion MRS combined with PSAD and fPSA/tPSA can improve the diagnostic accuracy of prostate cancer at serum PSA gray zone,which has the high application value in the diagnosis of PSA gray zone prostate cancer.

关 键 词：前列腺肿瘤 磁共振波谱成像 前列腺特异性抗原 

分 类 号：R737.25[医药卫生—肿瘤]