PSAD联合DCE-MRI对前列腺癌诊断价值的研究  

Diagnostic value of prostate specific antigen dencity combined with dynamic contrast-enhanced magnetic resonance imaging on prostate cancer

作　　者：罗潇[1] 何永胜[1] 徐琦[1] 戚轩 

机构地区：[1]马鞍山市人民医院影像科,安徽马鞍山243000

出　　处：《海南医学》2017年第10期1629-1632,共4页Hainan Medical Journal

基　　金：安徽省马鞍山市卫计委科教专项资金资助课题(编号:2014-J-Z-05)

摘　　要：目的探讨前列腺特异性抗原(PSA)、前列腺特异性抗原密度(PSAD)联合动态增强扫描磁共振成像(DCE-MRI)定量参数K^(trans)、K_(ep)、V_e对前列腺癌(PCa)的诊断价值。方法选取马鞍山市人民医院2015年5月至2016年6月前列腺患者66例,其中PCa 25例、前列腺增生(BPH)41例。所有患者均行DCE-MRI检查、PSA检测,将得出结果按照11种组合方案,参照病理结果,绘制受试者特性曲线(ROC),比较所有诊断方案的灵敏度、特异度及准确度。结果 BPH组患者的PSA、PSAD、K^(trans)、K_(ep)、V_e分别为(14.72±12.86)ng/mL、(0.25±0.23)ng/(mL·cm^3)、(0.22±0.10)/min、(1.35±0.59)/min、(0.17±0.07),PCa组患者分别为(30.42±23.90)ng/mL、(0.84±0.52)ng/(mL·cm^3)、(0.52±0.18)/min、(2.51±1.10)/min、(0.24±0.10),BPH组患者的参数均低于PCa组,差异均有显著统计学意义(P<0.01)。单参数诊断方案中K^(trans)诊断价值最高,灵敏度、特异度、AUC_(ROC)分别为85.7%、90.2%、0.93。PSAD+K^(trans)在11种组合方案中诊断价值最高,灵敏度、特异度、AUC_(ROC)分别为90.5%、95.1%、0.96。结论 PSAD及DCE-MRI定量参数K^(trans)、K_(ep)对前列腺癌有较好的诊断价值,PSAD联合K^(trans)为前列腺良恶性病变的鉴别诊断提供了重要的参考。Objective To investigate the diagnostic value of prostate specific antigen （PSA）, prostate specific antigen dencity （PSAD） combined with dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） quantita-tive parameters, Ktrans, Kep, Ve on prostate cancer （PCa）. Methods Sixty-six patients with PCa were collected from May 2015 to June 2016 in the People＇s Hospital of Ma＇anshan, including 25 cases of PCa and 41 cases of benign prostatic hy-perplasia （BPH）. All patients underwent DCE-MRI and PSA test. The results showed that the receiver operating charac-teristic curve （ROC） was drawn according to the results of 11 combinations and the pathological results, and the sensi-tivity, specificity and accuracy of all the diagnostic protocols were compared. Results The PSA, PSAD, K^trans, Kep and Ve values of the BPH group were （14.72 ± 12.86） ng/mL, （0.25 ± 0.23） ng/（mL·cm^3）, （0.22 ± 0.10）/min, （1.35 ± 0.59）/min, （0.17 ± 0.07）, which were significantly lower than （30.42 ± 23.90） ng/mL, （0.84 ± 0.52） ng/（mL·cm^3）, （0.52 ± 0.18）/min, （2.51 ± 1.10）/min, （0.24 ± 0.10） of PCa group, P〈0.01. The value of K^trans diagnosis in single parameter diagnosis was the highest, and the sensitivity, specificity and AUCROC were 85.7%, 90.2%, and 0.93, respectively. PSAD＋K^trans had the highest diagnostic value in 11 combinations, and the sensitivity, specificity and AUCROC were 90.5%, 95.1%, and 0.96, respectively. Conclusion PSAD and DCE-MRI quantitative parameters Ktrans, Kep have a good diagnostic value in pros-tate cancer. PSAD combined with Ktrans provides an important reference for the differential diagnosis of benign and malig-nant lesions of the prostate.

关 键 词：前列腺癌 前列腺特异性抗原 前列腺特异性抗原密度 磁共振成像 动态增强 

分 类 号：R737.25[医药卫生—肿瘤]