PI-RADS评分3分诊断临床有意义前列腺癌的危险因素分析  

Analysis of risk factors for PI-RADS scores 3 in the diagnosis of clinically significant prostate cancer

作　　者：薛苗新 刘莉[2] 尹健 刘全海[1] 高丹 裴昕奇 赵华才[1] XUE Miaoxin;LIU Li;YIN Jian;LIU Quanhai;GAO Dan;PEI Xinqi;ZHAO Huacai(Urology Department,Shaanxi Provincial People's Hospital,Xi'an 710068,China;Ultrasound Imaging Department,Shaanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]陕西省人民医院泌尿外科,陕西西安710068 [2]陕西省人民医院超声影像科,陕西西安710068

出　　处：《临床医学研究与实践》2024年第10期29-32,共4页Clinical Research and Practice

基　　金：2021年陕西省自然科学基础研究计划项目(No.2021JQ-908);2021年陕西省人民医院菁英人才项目(No.2021JY-47);2019年陕西省人民医院科研基金项目(No.2019YXM-04)。

摘　　要：目的探索前列腺影像报告与数据系统(PI-RADS)评分3分患者发生临床有意义前列腺癌(csPCa)的独立危险因素。方法选取2018年1月至2022年6月在陕西省人民医院泌尿外科接受前列腺系统穿刺PI-RADS评分3分的118例患者作为研究对象。采用Logistic回归分析明确csPCa的独立危险因素并通过受试者工作特征曲线(ROC)及曲线下面积(AUC)评估穿刺前游离前列腺特异性抗原/总前列腺特异性抗原(fPSA/tPSA)、前列腺特异性抗原密度(PSAD)、直肠指检单独及联合应用诊断csPCa的准确性。结果118例患者中,29例(24.58%)患者诊断为csPCa,89例(75.42%)患者诊断为非csPCa。多因素Logistic回归分析结果显示,fPSA/tPSA≤0.16、PSAD≥0.20 ng/mL^(2)及直肠指检异常是csPCa的独立危险因素(P<0.05)。fPSA/tPSA、PSAD及直肠指检诊断csPCa的AUC值分别为0.71、0.80、0.74,联合应用后的AUC值为0.91。结论穿刺前fPSA/tPSA≤0.16、PSAD≥0.20 ng/mL^(2)及直肠指检异常是csPCa的独立危险因素,联合应用可以显著提高csPCa的诊断准确性,值得临床推广和应用。Objective To explore the independent risk factors of clinically significant prostate cancer(csPCa)for patients with prostate imaing-reporting and data system(PI-RADS)scores 3.Methods From January 2018 to June 2022,118 patients with prostate system puncture PI-RADS scores 3 in the urology department of Shaanxi Provincial People's Hospital were selected as the research objects.Logistic regression analysis was used to identify the independent risk factors of csPCa,and the accuracy of free prostate-specific antigen/total prostate-specific antigen(fPSA/tPSA),prostate-specific antigen density(PSAD)and digital rectal examination alone and in combination for diagnosing csPCa was evaluated by receiver operating characteristic curve(ROC)and area under curve(AUC).Results Of the 118 patients,29 cases(24.58%)were diagnosed with csPCa and 89 cases(75.42%)were diagnosed with non-csPCa.Multivariate Logistic regression analysis showed that fPSA/tPSA≤0.16,PSAD≥0.20 ng/mL^(2) and abnormal digital rectal examination were independent risk factors for csPCa(P<0.05).The AUC values of fPSA/tPSA,PSAD and digital rectal examination in the diagnosis of csPCa were 0.71,0.80 and 0.74,respectively,and the AUC value after combined application was 0.91.Conclusion Before biopsy fPSA/tPSA≤0.16,PSAD≥0.20 ng/mL^(2) and abnormal digital rectal examination are independent risk factors for csPCa,and the combined application can significantly improve the diagnostic accuracy of csPCa,which is worthy of clinical promotion and application.

关 键 词：临床有意义前列腺癌 前列腺影像报告与数据系统评分 危险因素 前列腺穿刺 前列腺特异性抗原密度 

分 类 号：R737.25[医药卫生—肿瘤]