f-PSA/t-PSA联合基于PI-RADS v2评分的多参数MRI在前列腺癌中的诊断价值  

Diagnostic value of f-PSA/t-PSA combined with multi-parameter MRI based on PI-RADS v2 score in prostate cancer

作　　者：李媛媛 张显利 LI Yuanyuan;ZHANG Xianli(Xianyang Central Hospital,Xianyang 712000,China)

机构地区：[1]咸阳市中心医院,陕西咸阳712000

出　　处：《临床医学研究与实践》2022年第28期119-122,136,共5页Clinical Research and Practice

摘　　要：目的探究游离型前列腺特异性抗原/总前列腺特异性抗原(f-PSA/t-PSA)联合基于前列腺影像报告和数据系统第2版(PI-RADS v2)评分的多参数磁共振成像(MRI)在前列腺癌中的诊断价值。方法选取本院收治的82例疑似前列腺癌患者,均开展MRI常规平扫、弥散加权成像(DWI)、动态增强磁共振成像(DCE-MRI)扫描,统计PI-RADS v2评分,检测血清f-PSA和t-PSA水平,并计算f-PSA/t-PSA。以病理结果为诊断金标准,对比MRI常规平扫、DWI、DCE-MRI、PI-RADS v2评分、f-PSA/t-PSA以及f-PSA/t-PSA联合PI-RADS v2评分对前列腺癌的诊断效能。结果病理结果显示,前列腺癌42例,非前列腺癌40例。前列腺癌患者的f-PSA、t-PSA水平高于非前列腺癌患者,f-PSA/t-PSA小于非前列腺癌患者(P<0.05)。前列腺癌患者的体积转运常数(K^(trans))和速率常数(K_(ep))均明显高于非前列腺癌患者,ADC值明显小于非前列腺癌患者(P<0.05)。f-PSA/t-PSA联合PI-RADS v2评分和PI-RADS v2评分诊断前列腺癌的灵敏度、特异度、准确度、阳性预测值、阴性预测值均明显高于MRI常规平扫、DWI、DCE-MRI、f-PSA/t-PSA(P<0.05)。PI-RADS v2评分、f-PSA/t-PSA联合PI-RADS v2评分诊断结果与病理结果具有极高的一致性(Kappa值分别为0.8289、0.9511)。结论f-PSA/t-PSA联合PI-RADS v2评分诊断前列腺癌的效能比较高,但与PI-RADS v2评分的统计学差异不大,建议临床在有条件的情况下广泛地推广应用PI-RADS v2评分,必要时联合f-PSA/t-PSA。Objective To explore the diagnostic value of free prostate specific antigen/total prostate specific antigen(f-PSA/t-PSA)combined with multi-parameter magnetic resonance imaging(MRI)based on Prostate Imaging Reporting and Data System Version 2(PI-RADS v2)score in prostate cancer.Methods Eighty-two patients with suspected prostate cancer admitted in our hospital were selected.Routine MRI plain scan,diffusion weighted imaging(DWI)and dynamic enhanced magnetic resonance imaging(DCE-MRI)were performed.PI-RADS v2 score was counted,serum f-PSA and t-PSA levels were detected,and f-PSA/t-PSA was calculated.Taking pathological results as the gold standard for diagnosis,the diagnostic efficacy of routine MRI plain scan,DWI,DCE-MRI,PI-RADS v2 score,f-PSA/t-PSA and f-PSA/t-PSA combined with PI-RADS v2 score for prostate cancer were compared.Results Pathological results showed that there were 42 cases of prostate cancer and 40 cases of non-prostate cancer.The levels of f-PSA and t-PSA in prostate cancer patients were higher than those in non-prostate cancer patients,and the f-PSA/t-PSA was smaller than that in non-prostate cancer patients(P<0.05).The volume transfer constant(K^(trans))and rate constant(K_(ep))of prostate cancer patients were significantly higher than those of non-prostate cancer patients,and the ADC value was significantly smaller than that of non-prostate cancer patients(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of f-PSA/t-PSA combined with PI-RADS v2 score and PI-RADS v2 score in the diagnosis of prostate cancer were significantly higher than those of routine MRI plain scan,DWI,DCE-MRI and f-PSA/t-PSA(P<0.05).The diagnostic results of PI-RADS v2 score,f-PSA/t-PSA combined with PI-RADS v2 score were highly consistent with the pathological results(Kappa values were 0.8289 and 0.9511,respectively).Conclusion The f-PSA/t-PSA combined with PI-RADS v2 score is more effective in the diagnosis of prostate cancer,but there is little statistical difference bet

关 键 词：前列腺癌 前列腺影像报告和数据系统第2版 游离型前列腺特异性抗原/总前列腺特异性抗原 

分 类 号：R737.25[医药卫生—肿瘤]