磁共振结合经直肠超声在各PSA区间对前列腺癌的诊断价值  

Diagnostic Value of MRI Combined TRUS for Prostate Cancer at Different Prostate-specific Antigen (PSA) Levels

作　　者：苏冠宇[1] 毛晓鹏[1] 莫承强[1] 李柏谋 陈旭[1] 庄锦涛[2] 丘少鹏[1] SU Guan-yu MAO Xiao-peng MO Cheng-qiang LI Bai-mou CHEN Xu ZHUANG Jin-tao QIU Shao- peng(Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhon 510080, China Department of Urology, Eastern Hospital of the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510070, China)

机构地区：[1]中山大学附属第一医院泌尿外科,广东广州510080 [2]中山大学附属第一医院东院泌尿外科,广东广州510070

出　　处：《中山大学学报（医学科学版）》2017年第1期133-137,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家自然科学基金(81001146);广东省科技计划项目(2012B031800033)

摘　　要：【目的】探讨磁共振(MRI)结合经直肠超声(TRUS)在不同前列腺特异性抗原(PSA)区间对前列腺癌的诊断价值。【方法】搜集2014年11月至2016年6月在我院的278例患者的临床资料。纳入研究的病例穿刺前均进行了PSA血清学检查,MRI以及TRUS的影像学检查。278例患者分别按PSA水平4~10 ng/m L、10~20 ng/m L、大于20 ng/m L分为A、B、C3组。对3组的MRI结合TRUS的诊断率进行了回顾性分析。【结果】A组MRI+TRUS与TRUS的ROC面积分别为0.73和0.59(P=0.02);B组MRI+TRUS与TRUS的ROC面积分别为0.68和0.56(P<0.001);C组MRI+TRUS与TRUS的ROC面积分别为0.74和0.63(P<0.001)。B、C两组具有更显著的统计学差异。【结论】MRI结合TRUS在不同PSA水平对前列腺癌的诊断效能均优于单纯的TRUS,表明MRI结合TRUS是提高前列腺癌穿刺检出率的有效方案。【Objective】To explore the diagnostic value of magnetic resonance imaging（MRI）combined transrectal ultrasound（TRUS）to guide prostate cancer detection at different serum prostate-specific antigen（PSA）levels.【Methods】Totally 278 patients who underwent a systematic biopsy were collected in our hospital from November 2014 to June 2016. Preoperative tests of PSA,MRI,TRUS were performed in all the included patients. According to the PSA level of 4 - 10 ng/mL,10 - 20 ng/mL,over 20 ng/mL,278 cases were divided into three group of A,B,C. Retrospective analysis was performed within the three groups of diagnostic accuracy.【Results】In Group A,the areas under ROC for MRI＋TRUS and TRUS were 0.73 and 0.59,respectively（P = 0.02）. In Group B,the areas under ROC for MRI＋TRUS and TRUS were 0.68 and 0.56,respectively（P 〈0.001）. In Group C,the area under ROC for MRI＋TRUS and TRUS were 0.74 and 0.63,respectively（P〈 0.001）. There is more significant statistical difference in Group B and C.【Conclusion】MRI combined TRUS has higher diagnostic value in cancer detection than TRUS before biopsy between different PSA levels,which Indicates that MRI combined TRUS is an effective method for the improvement of prostate cancer detection.

关 键 词：前列腺特异性抗原 磁共振成像 经直肠超声 前列腺穿刺 

分 类 号：R69[医药卫生—泌尿科学]