血清PSA联合双参数磁共振成像对前列腺癌的诊断效能分析  

Analysis of Diagnostic Efficacy of Serum PSA Combined with Biparametric Magnetic Resonance Imaging for Prostate Cancer

作　　者：梁雯雯 黄丙仓[1] 陆炜平 汪波 陈杰[1] 张鹤[2] LIANG Wen-wen;HUANG Bing-cang;LU Wei-ping;WANG Bo;CHEN Jie;Zhang He(Department of Imaging,Gongli Hospital,Pudong New Area,Shanghai 200135,China;Department of Urology,Gongli Hospital,Pudong New Area,Shanghai 200135,China)

机构地区：[1]上海市浦东新区公利医院影像科,上海200135 [2]上海市浦东新区公利医院泌尿外科,上海200135

出　　处：《中国CT和MRI杂志》2024年第5期134-136,共3页Chinese Journal of CT and MRI

基　　金：浦东新区卫生系统优秀青年医学人才项目(PWRq2021-29);浦东新区卫健委面上项目(PW2021A-44);浦东新区卫生系统重点学科建设项目(PWZxk2022-03)。

摘　　要：目的分析双参数磁共振成像(MRI)联合血清前列腺特异性抗原(PSA)诊断前列腺癌的价值。方法回顾性收集和分析本院病理科数据库中前列腺疾病患者临床资料,依照病理检查结果分为前列腺癌126例(前列腺癌组)和前列腺良性增生104例(对照组)。患者术前均进行双参数MRI检查,采用化学发光免疫分析法对血清PSA水平进行定量检测;绘制ROC曲线对不同指标的诊断价值进行分析;Kappa一致性检验对不同指标与病理结果的一致性进行分析。结果前列腺癌组患者血清PSA水平显著高于对照组患者(P<0.05)。T_(2)WI、DWI与病理结果比较的Kappa值分别为0.679、0.703(P<0.05)。双参数MRI、PSA单独及联合诊断前列腺癌的AUC分别为0.893、0.772、0.955(P<0.05)。双参数MRI、PSA及联合检查结果与病理结果比较的Kappa值分别为0.775、0.475、0.895(P<0.05)。双参数MRI联合血清PSA鉴别诊断前列腺癌的准确度、敏感度、阴性预测值显著高于二者单独诊断,特异度、阳性预测值显著高于血清PSA单独诊断(P<0.05)。结论双参数MRI、PSA均对前列腺癌有一定诊断效能,且将其联合后可进一步提高诊断价值,可考虑在临床中推广使用。Objective To analyze the value of biparametric magnetic resonance imaging(bpMRI)combined with serum prostate specific antigen(PSA)in the diagnosis of prostate cancer.Methods Clinical data of patients with prostate diseases in the pathology database of our hospital were retrospectively collected and analyzed.According to the pathological examination results,they were grouped into 126 cases of prostate cancer(prostate cancer group)and 104 cases of benign prostatic hyperplasia(reference group).All patients underwent biparametric MRI examination before surgery,chemiluminescence immunoassay was applied to quantitatively detect serum PSA level;ROC curve was plotted to analyze the diagnostic value of different indicators;Kappa consistency test was applied to analyze the consistency between different indicators and pathological results.Results The serum PSA level in the prostate cancer group was obviously higher than that in the reference group(P<0.05).The Kappa values of T_(2)WI and DWI compared with pathological results were 0.679 and 0.703,respectively(P<0.05).The AUC of biparametric MRI,PSA alone and in combination for diagnosing prostate cancer was 0.893,0.772,and 0.955,respectively(P<0.05).The Kappa values of biparametric MRI,PSA,and combined examination compared with pathological results were 0.775,0.475,and 0.895,respectively(P<0.05).The accuracy,sensitivity,and negative predictive value of biparametric MRI combined with serum PSA in differential diagnosis of prostate cancer were obviously higher than those of the two individual diagnoses,while the specificity and positive predictive value were obviously higher than those of serum PSA individual diagnoses(P<0.05).Conclusion biparametric MRI,PSA all have certain diagnostic efficacy for prostate cancer,and their combination can further improve diagnostic value,which can be considered for clinical promotion.

关 键 词：前列腺癌 双参数磁共振成像 前列腺特异性抗原 诊断 

分 类 号：R737.25[医药卫生—肿瘤]