血清前列腺特异抗原、直肠指检联合磁共振波谱成像对前列腺癌的诊断价值  

The diagnostic value of serum prostate specific antigen,digital rectal examination combined with magnetic resonance spectroscopy on prostate cancer

作　　者：郭小鹏[1] 成俊[1] 王鹏[1] 

机构地区：[1]新疆医科大学第四附属医院泌尿外科,新疆乌鲁木齐830000

出　　处：《中国实验诊断学》2016年第3期381-384,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨血清前列腺特异抗原(PSA)、直肠指检(DRE)联合磁共振波谱成像(MRS)对前列腺癌的诊断价值。方法以107经超声检查发现前列腺占位或前列腺增生患者作为对象,所有患者均行血清PSA检查且PSA均异常,后接受MRS和DRE,根据PSA水平将患者分为PSA高危组(>20ng/ml)、PSA中危组(10-20ng/ml)、PSA低危组(4-10ng/ml),所有患者均接受手术或穿刺活检取得病理标本,以病理诊断作为最后诊断结果,分析MRS、DRE对不同血清PSA组、MRS+DRE以及MRS+DRE+PSA高危对前列腺癌的诊断价值。结果 107例患者病理诊断为前列腺癌的56例,非前列腺癌51例,MRS诊断为前列腺癌57例,非前列腺50例,MRS诊断结果与病理诊断结果一致性良好(P<0.05);MRS+PSA低危、RS+PSA中危、MRS+PSA高危诊断前列腺癌的准确性分别为70.83%、81.48%、93.75%,不同PSA水平组间MRS诊断效能不同,三种方法比较差异有统计学意义(χ2=6.201,P<0.05);MRS+DRE、MRS+PSA高危、MRS+DRE+PSA高危诊断准确率分别为90.65%、93.75%、96.88%,均显著高于单纯MRS诊断的80.37%,差异有统计学意义(χ2=5.231、5.661、6.294,均P<0.05)。结论 MRS在前列腺癌的诊断中具有较高的应用价值,联合血清PSA或(和)DRE能进一步提高诊断的准确率。Objective To explore the diagnostic value of serum prostate specific antigen（PSA）,digital rectal examination（DRE）,combined with magnetic resonance spectroscopy（MRS）,on prostate cancer.Methods 107 cases patients with prostatic hyperplasia or prostate placeholder checked by ultrasound examination,they were with serum PSA test and the PSA were abnormal,then they were checked by MRS and DRE,they were divided into PSA high-risk group（〉20ng/ml）,PSA moderate group（10-20ng/ml）,PSA low-risk group（4-10ng/ml）according to PSA leves,all patients were with undergoing surgery or biopsy pathologic specimens and were with a final diagnosis of pathological diagnosis results,analysed the diagnostic value of MRS,MRS with different serum PSA group,MRS＋DRE and MRS＋DRE＋PSA high-risk.Results The pathological diagnosis showed that there were 56 cases prostate cancer another 51 cases without prostate cancer,while MRS diagnosed that there were 57 cases prostate cancer another 50 cases without prostate cancer,MRS diagnosis and pathological diagnosis results were in good consistency（P〈0.05）;The diagnosis accuracy of MRS＋PSA low-risk group,MRS＋PSA moderate group and MRS＋PSA high-risk group were 70.83%,81.48%,93.75%,the MRS diagnosis was efficiency between different PSA group,the difference was statistically significant（χ2=6.201,P〈0.05）;The diagnosis accuracy of MRS＋DRE,MRS＋PSA high-risk and MRS＋DRE＋PSA high-risk were 90.65%,93.75%,96.88%,they were significantly higher than that of pure MRS diagnosis,the difference was statistically significant（χ2=5.231、5.661、6.294,all P〈0.05）.Conclusion MRS has a high application value in the diagnosis of prostate cancer,joint serum PSA or（and）DRE can further improve the diagnostic accuracy.

关 键 词：前列腺特异抗原 直肠指检 磁共振波谱成像 前列腺癌 诊断 

分 类 号：R737.25[医药卫生—肿瘤]