前列腺影像报告和数据系统对经会阴认知融合靶向穿刺诊断前列腺癌的预测价值  

Predictive Value of Prostate Imaging Reporting and Data System for the Outcome of Transperineal Cognitive Fusion-Targeted Biopsy

作　　者：赵旭 霍日查[1] 邢征宇 王东艳 林方明 张强 ZHAO Xu;HUO Richa;XING Zhengyu;WANG Dongyan;LIN Fangming;ZHANG Qiang(Department of Urology,Central Clinical Medical College,Baotou Medical College,Baotou 014040,China;不详)

机构地区：[1]包头医学院中心临床医学院泌尿外科,内蒙古包头014040 [2]山东大学附属公共卫生临床中心山东省公共卫生临床中心泌尿外科,山东济南250013 [3]内蒙古自治区包头市中心医院影像科,内蒙古包头014040

出　　处：《中国医学影像学杂志》2023年第8期872-876,881,共6页Chinese Journal of Medical Imaging

基　　金：2021年度包头市青年创新人才项目。

摘　　要：目的 探究基于多参数MRI的前列腺影像报告和数据系统(PI-RADS)在经会阴认知融合靶向穿刺诊断前列腺癌的预测价值。资料与方法 回顾性分析2018年10月—2021年9月包头市中心医院疑似前列腺癌并初次接受经会阴前列腺活检的患者93例,穿刺前行多参数MRI并根据影像学特点进行PI-RADS评分。评价PI-RADS评分与总前列腺特异性抗原、Gleason评分的相关性;计算PI-RADS评分的敏感度、特异度等,并绘制受试者工作特征曲线评价其对前列腺癌的诊断价值。结果 不同总前列腺特异性抗原水平分层的PI-RADS评分差异有统计学意义(χ^(2)=24.889,P<0.001),随着PI-RADS分值升高,术后Gleason评分呈逐渐上升趋势(χ^(2)=42.546,P<0.001);二元Logistic回归表明PI-RADS评分是穿刺结果为阳性的重要预测因素(OR=4.425,95%CI 2.531~7.736,P<0.05),受试者工作特征曲线显示PI-RADS评分的曲线下面积为0.860,优于前列腺特异性抗原密度、总前列腺特异性抗原、年龄等因素;PI-RADS评分≥4分为预测前列腺癌的最佳阈值,其诊断敏感度为80.00%,特异度为81.58%。结论 PI-RADS评分系统可以有效预测经会阴认知融合靶向穿刺结果,以PI-RADS≥4分为预测前列腺癌的最佳临界值。Purpose To explore the predictive value of prostate imaging reporting and data system(PI-RADS) based on multi-parameter magnetic resonance imaging(mpMRI) in the diagnosis of prostate cancer via transperineal cognitive fusion-targeted biopsy.Materials and Methods A total of 93 patients with suspected prostate cancer who first received transperineal prostate biopsy from October 2018 to September 2021 in Baotou Central Hospital were retrospectively analyzed.All patients performed mpMRI scan before biopsy,and PI-RADS score was performed according to imaging characteristics.The correlation of PI-RADS score with total prostate specific antigen(tPSA) and Gleason score was evaluated,respectively.The sensitivity and specificity of PI-RADS score were calculated,and the receiver operating characteristic curve was drawn to evaluate its diagnostic value for prostate cancer.Results There was significant difference in result of PIRADS scores among different levels of tPSA(χ^(2)=24.889,P<0.001).With the increase of PI-RADS score,Gleason score showed a gradual upward trend(χ^(2)=42.546,P<0.001).The Logistic regression showed that PI-RADS score was an important predictor of positive puncture results(OR=4.425,95% CI 2.531-7.736,P<0.05).Receiver operating characteristic curve showed that the area under the curve of PI-RADS score was 0.860,which was better than that of PSA density,tPSA and age.The optimal threshold for predicting prostate cancer was PIRADS≥4,and its diagnostic sensitivity was 80.00% and specificity was 81.58%.Conclusion PI-RADS can effectively predict the outcome of the transperineal cognitive fusion-targeted biopsy,and PI-RADS≥4 may be the optimal threshold for the prediction of prostate cancer.

关 键 词：影像引导活检 活组织检查 前列腺肿瘤 磁共振成像 预测 预警评分 

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