PSADR、DPC及TSRP在PI-RADS评分3分前列腺穿刺患者中的应用价值  

The diagnostic value of PSADR,DPC and TSRP in patients with PI-RADS of 3 undergoing prostate biopsy

作　　者：何民心 种铁[2] 马继霞 王红 刘芳 李明睿 薛力[2] HE Minxin;CHONG Tie;MA Jixia;WANG Hong;LIU Fang;LI Mingrui;XUE Li(Medical Science Center,Xi'an Jiaotong University,Xi'an 710061;Department of Urology,Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学医学部,陕西西安710061 [2]西安交通大学第二附属医院泌尿外科,陕西西安710004

出　　处：《现代泌尿外科杂志》2021年第8期646-650,共5页Journal of Modern Urology

基　　金：西安市科技计划项目[No.2019114613YX001SF040(8)]。

摘　　要：目的研究前列腺特异性抗原(PSA)周下降速率(PSADR)、前列腺塌陷程度(DPC)及前列腺组织信号比(TSRP)与前列腺影像报告和数据系统(PI-RADS)评分相结合在前列腺癌(PCa)与前列腺炎性疾病鉴别诊断中的价值。方法回顾性分析74例PSA>10 ng/mL的前列腺穿刺患者的临床资料,根据病理结果分为PCa组与前列腺炎性疾病组。以最新PI-RADS V2.1评分为基础,采用双参数MRI(bp MRI)评分方案对研究对象的MRI图像进行评分。选出PI-RADS评分为3分的患者,收集其PSADR、DPC及TSRP协助诊断。最后,将诊断结果与最终的病理结果相对比,寻求PSADR、DPC及TSRP与PI-RADS评分相结合在PCa与前列腺炎性疾病鉴别诊断中的价值。结果在所有患者中,PI-RADS评分为3分者共有25例,其中11例为PCa,14例为前列腺炎性疾病。对于PI-RADS评分为3分的患者,当结合PSADR、DPC及TSRP时,PCa的诊断敏感性为81.82%,诊断特异性为92.86%。结论PSADR、DPC和TSRP相结合可被用于PI-RADS评分3分患者前列腺穿刺前的炎性疾病与癌的鉴别,减少不必要的前列腺穿刺。Objective To investigate the diagnostic value of prostate specific antigen(PSA),PSA decline rate per week(PSADR),degree of prostatic collapse(DPC),and tissue signal rate of prostate(TSRP)with prostate imaging reporting and data system(PI-RADS)score in the differentiation of prostatitis and prostate cancer.Methods The clinical data of 74 patients undergoing prostate biopsy were retrospectively analyzed.The patients were divided into two groups:prostatitis group and prostate cancer group,according to pathological results.On the basis of the newest PI-RADS V2.1 score,the MRI images of patients were scored with biparametric MRI(bp MRI).Patients with PI-RADS score of 3 were selected,and their data of PSADR,DPC and TSRP were collected to help differentiate prostatitis from prostate cancer.And the diagnostic value was assessed.Results In all patients,25 had PI-RADS score of 3,among whom 11 had prostate cancer,and 14 had prostatitis.For these patients,the sensitivity and specificity of the combination of PSADR,DPC and TSRP in the diagnosis of prostate cancer were 81.82%and 92.86%,respectively.Conclusion Combination of PSADR,DPC and TSRP can help the differentiation of prostatitis from prostate cancer in patients with PI-RADS score of 3,thereby reducing unnecessary prostate biopsy.

关 键 词：PSA周下降速率 前列腺塌陷程度 前列腺组织信号比 前列腺炎性疾病 前列腺癌 鉴别诊断 PI-RADS 3分 

分 类 号：R697.3[医药卫生—泌尿科学]