前列腺特异性抗原密度、相对表观扩散系数在前列腺癌中的鉴别诊断价值  

The differential diagnostic value of prostate specific antigen density and relative apparent diffusion coefficient in prostate cancer

作　　者：李守斌 李慧[1] 汪军[1] 吴津民[1] 王啸[1] 钱银锋[1] LI Shoubin;LI Hui;WANG Jun;WU Jinmin;WANG Xiao;QIAN Yinfeng(Department of Radiology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院放射科,安徽合肥230022

出　　处：《实用放射学杂志》2022年第8期1314-1316,1333,共4页Journal of Practical Radiology

摘　　要：目的探讨前列腺特异性抗原密度(PSAD)、相对表观扩散系数(rADC)鉴别诊断前列腺癌的应用价值.方法回顾性选取经病理证实的35例前列腺癌患者和13例非前列腺癌患者,设为前列腺癌组和非前列腺癌组,测量病变区表观扩散系数(ADC)值及对侧ADC值,计算rADC(病变ADC值/对侧ADC值),收集患者的前列腺特异性抗原(PSA),所有患者均行MRI扫描,通过前列腺轴位,冠状位和矢状位T_(2)WI图像,测量前列腺的上下径、左右径和前后径,通过公式计算出前列腺体积(V),最后计算出PSAD(PSAD=PSA/V),比较2组间的PSAD、rADC差异有无统计学意义,并绘制受试者工作特征(ROC)曲线评估诊断的准确性.结果前列腺癌组PSAD、rADC和非前列腺癌组之间均有统计学差异(P<0.001),PSAD的最佳诊断临界值为0.255 ng/mL·cm^(3),敏感度为77.1%,特异度为84.6%,曲线下面积(AUC)为0.840.rADC的最佳诊断临界值为0.550,敏感度为62.9%,特异度为100%,AUC为0.887.将PSAD、rADC 2个指标联合,所得AUC为0.949.结论PSAD、rADC可以辅助前列腺癌的鉴别诊断,单指标诊断时rADC的诊断效能优于PSAD.PSAD、rADC联合诊断时准确性最高,优于任意一个单指标诊断效能.Objective To discuss the application value of prostate specific antigen density(PSAD)and relative apparent diffusion coefficient(rADC)in differential diagnosis of prostate cancer.Methods35 patients with prostate cancer and 13 patients without prostate cancer confirmed by pathology were collected retrospectively.They were divided into prostate cancer group and non-prostate cancer group.The apparent diffusion coefficient(ADC)value of the lesion area and contralateral ADC value were measured,and rADC(lesion ADC value/contralateral ADC value)were calculated.Prostate specific antigen(PSA)of two groups patients were collected.All patients were scanned by MRI.The up-down diameter,left-right diameter and front-back diameter of prostate were measured by axial,coronal and sagittal T_(2)WI images of prostate.The prostate volume(V)was calculated by the formula,and finally PSAD(PSAD=PSA/V)was calculated.PSAD and rADC between the two groups were compared,and reeiver operating characteristic(ROC)curve was to evaluate the accuracy of diagnosis.ResultsThere were significant dfferences in PSAD and rADC between prostate cancer group and non-prostate cancer group(P<0.001).The optimal diagnostic threshold of PSAD was 0.255 ng/mL·cm^(3),the sensitivity was 77.1%,the specificity was 84.6%,and the area under the curve(AUC)was 0.840.The optimal diagnostic threshold of rADC was 0.550,the sensitivity was 62.9%,the specificity was 100%,and the AUC was 0.887.Combining PSAD and rADC,the AUC was 0.949.Conclusion PSAD and rADC can assist the differential diagnosis of prostate cancer,and the diagnostic efficiency of rADC is better than PSAD in single index diagnosis.Combining PSAD and rADC has the highest accuracy,which is better than any single index diagnosis efficiency.

关 键 词：前列腺癌 前列腺特异性抗原密度 相对表观扩散系数 

分 类 号：R737.25[医药卫生—肿瘤] R445.2[医药卫生—临床医学]