PI-RADS v2.1联合临床指标对前列腺移行带临床显著癌的诊断效能研究  

Diagnostic value of PI-RADS v2.1 combined with clinical indicators for clinically significant cancer in the transitional zone of the prostate

作　　者：孙家元 王天乐 SUN Jiayuan;WANG Tianle(Department of Imaging,the People’s Hospital of Rugao,Nantong,Jiangsu Province 226500,China;Department of Imaging,the Second Affiliated Hospital of Nantong University,Nantong,Jiangsu Province 226000,China)

机构地区：[1]如皋市人民医院影像科,江苏南通226500 [2]南通大学第二附属医院影像科,江苏南通226000

出　　处：《实用放射学杂志》2023年第12期1990-1994,共5页Journal of Practical Radiology

基　　金：如皋市科技计划项目[SRG(22)1081]。

摘　　要：目的探讨2.1版前列腺影像报告和数据系统(PI-RADS v2.1)评分为3分或4分时联合临床指标对移行带临床显著前列腺癌(csPCa)的诊断价值。方法回顾性分析251例经病理证实的移行带病变患者相关资料,分析csPCa及非csPCa患者年龄、前列腺特异性抗原(PSA)、前列腺体积(PV)及相关衍生指标的组间差异,确定诊断移行带csPCa的独立影响因素,通过计算最佳诊断阈值、绘制受试者工作特征(ROC)曲线,比较各因素单独及联合应用时诊断性能差异。结果251例患者中非csPCa组188例,csPCa组63例,单因素及多因素分析显示前列腺特异性抗原密度(PSAD)[比值比(OR)=3.745]及PV(OR=0.98)为诊断移行带csPCa的独立影响因素(P<0.05)。最佳诊断阈值:PSAD>0.22 ng/(mL·cm^(3)),PV≤46.95 cm^(3),联合应用时诊断性能高于PI-RADS v2.1及PV[曲线下面积(AUC)分别为0.791、0.661、0.703],但与PSAD单独诊断性能相当,差异无统计学意义(Z=1.423,P=0.1548)。结论当PI-RADS v2.1评分为3分或4分时,联合临床指标可改善其对移行带csPCa的诊断,应当重视PSAD以及PV的价值。Objective To explore the diagnostic value of combined clinical factors for transitional zone clinically significant prostate cancer(csPCa)in the lesion with category 3 or 4 of prostate imaging reporting and data system version 2.1(PI-RADS v2.1).Methods The data of 251 patients of pathologically confirmed transitional zone lesions were analyzed retrospectively,the age,prostate specific antigen(PSA),prostate volume(PV)and the related derived indicators in patients with csPCa and non-csPCa were analyzed.To determine independent predictors for the diagnosis of csPCa.Receiver operating characteristic(ROC)curve was used to assess the diagnostic efficacy when each factor was applied individually and in combination,and the optimal diagnostic threshold was also calculated.Results There were 188 cases in the non-csPCa group and 63 cases in the csPCa group in 251 patients.Univariate and multivariate logistic regression analysis showed prostate specific antigen density(PSAD)[odds ratio(OR)=3.745]and PV(OR=0.98)were independent predictors of csPCa(P<0.05),and the optimal diagnostic threshold was:PSAD>0.22 ng/(mL·cm^(3)),PV≤46.95 cm^(3),the combined diagnostic performance was higher than that of PI-RADS v2.1 and PV alone[area under the curve(AUC):0.791,0.661,0.703],but comparable to that of PSAD alone,the difference was no statistically significant(Z=1.423,P=0.1548).Conclusion Combined clinical factors can improve the diagnostic performance for csPCa in the transitional zone in the lesion with category 3 or 4 of PI-RADS v2.1,the value of PSAD and PV should be paid attention to.

关 键 词：前列腺影像报告与数据系统 前列腺特异性抗原密度 前列腺体积 前列腺癌 

分 类 号：R445[医药卫生—影像医学与核医学] R737.25[医药卫生—诊断学]