实时组织弹性成像峰值应变指数联合FPSA/TPSA在PSA灰区前列腺癌鉴别诊断中的应用价值  

Application value of real-time tissue elastography peak strain index combined with FPSA/TPSA in differential diagnosis of prostatic cancer in gray area of PSA

作　　者：周亚翠 李海珍 屈婉红 李志丹 ZHOU Yacui;LI Haizhen;QU Wanhong;LI Zhidan(Baoji Fengxiang Hospital,Baoji 721400;Baoji Central Hospital,Baoji 721000,China)

机构地区：[1]宝鸡市凤翔区医院,陕西宝鸡721400 [2]宝鸡市中心医院,陕西宝鸡721000

出　　处：《临床医学研究与实践》2023年第35期96-99,共4页Clinical Research and Practice

基　　金：宝鸡市卫生健康委员会2019年度科研计划立项课题(No.2019-76)。

摘　　要：目的研究实时组织弹性成像峰值应变指数(PSI)联合游离前列腺特异性抗原/总前列腺特异性抗原(FPSA/TPSA)在前列腺特异性抗原(PSA)灰区前列腺癌鉴别诊断中的应用价值。方法纳入2018年1月至2022年5月收治的疑似前列腺癌患者95例,根据病理检查结果,将32例前列腺癌患者纳入前列腺癌组,63例非前列腺癌患者纳入对照组。比较前列腺癌组和对照组的弹性成像评分、PSI、整体的应变指数(ASI)、FPSA、TPSA水平以及FPSA/TPSA;使用二元Logistic逐步回归建立PSA灰区前列腺癌的联合预测回归模型;使用受试者工作特征(ROC)曲线分析PSI、FPSA/TPSA单独以及联合诊断对PSA灰区前列腺癌的诊断价值。结果前列腺癌组的弹性成像评分、PSI以及ASI均明显高于对照组,差异具有统计学意义(P<0.05)。前列腺癌组的FPSA水平、FPSA/TPSA均明显低于对照组,差异具有统计学意义(P<0.05)。二元Logistic逐步回归分析中,联合预测回归模型:Logit(P)=-3.366+0.298×PSI-17.871×FPSA/TPSA。ROC曲线显示,PSI联合FPSA/TPSA诊断PSA灰区前列腺癌的曲线下面积(AUC)最高,为0.916。结论实时组织弹性成像PSI联合FPSA/TPSA对PSA灰区前列腺癌的诊断价值较高,值得临床上推广应用。Objective To study the application value of real-time tissue elastography peak strain index(PSI)combined with free prostate specific antigen/total prostate specific antigen(FPSA/TPSA)in the differential diagnosis of prostatic cancer in gray area of prostate specific antigen(PSA).Methods Ninety-five patients with suspected prostatic cancer admitted from January 2018 to May 2022 were included.According to the pathological examination results,32 patients with prostatic cancer were included in prostatic cancer group and 63 patients without prostatic cancer were included in control group.Elastic imaging score,PSI,average strain index(ASI),FPSA,TPSA and FPSA/TPSA were compared between the prostatic cancer group and the control group;binary Logistic stepwise regression was used to establish the combined prediction regression model of prostatic cancer in gray area of PSA;the receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of PSI,FPSA/TPSA alone and in combination for prostatic cancer in gray area of PSA.Results The elastic imaging score,PSI and ASI in the prostatic cancer group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The FPSA level and FPSA/TPSA in the prostatic cancer group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).In the binary Logistic stepwise regression analysis,the joint prediction regression model:Logit(P)=-3.366+0.298×PSI-17.871×FPSA/TPSA.The ROC curve showed that PSI combined with FPSA/TPSA had the highest area under curve(AUC)of 0.916 in the diagnosis of prostatic cancer in gray area of PSA.Conclusion Real-time tissue elastography PSI combined with FPSA/TPSA has a higher diagnostic value for prostatic cancer in gray area of PSA and is worthy promotion and application in clinic.

关 键 词：实时组织弹性成像 峰值应变指数 游离前列腺特异性抗原 总前列腺特异性抗原 前列腺特异性抗原灰区 前列腺癌 

分 类 号：R737.25[医药卫生—肿瘤]