基于前列腺癌原发灶的双参数MRI纹理分析及血清PSA与术后骨转移的关系分析  

Analysis of the Relationship between Serum PSA and Postoperative Bone Metastases Based on Two-parameter MRI Texture Analysis of Prostate Cancer Primary Lesions

作　　者：贾俊芳 李文娟 徐志宾[1] JIA Jun-fang;LI Wen-juan;XU Zhi-bin(Imaging Center of the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan Province,China)

机构地区：[1]河南科技大学第一附属医院影像中心,河南洛阳471003

出　　处：《中国CT和MRI杂志》2024年第7期144-146,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨基于前列腺癌原发灶的双参数磁共振成像(bpMRI)纹理分析及血清前列腺特异抗原(PSA)与术后骨转移的关系。方法选取2019年1月至2022年1月期间我院收治的前列腺癌患者134例。患者入院需进行bpMRI及血清PSA检查,且行腹腔镜前列腺根治术,随访1年,根据术后骨转移情况将患者分为转移组(n=62)和未转移组(n=66)。采用Logistic回归模型分析相关危险因素。用受试者工作特征曲线(ROC)评估预测价值。结果2组表观弥散系数(ADC)峰度、ADC偏度及T_(2)WI峰度、T_(2)WI偏度比较,差异无统计学意义(P>0.05)。转移组ADC熵、T_(2)WI熵均高于未转移组(P<0.05)。2组患者年龄、临床分期、合并高血压、合并糖尿病、肿瘤直径比较,差异无统计学意义(P>0.05)。转移组Gleason病理评分、碱性磷酸酶(ALP)及血清PSA水平高于未转移组,血红蛋白(Hb)水平则低于未转移组(P<0.05)。多因素Logistic回归分析显示,高ADC熵、T_(2)WI熵及Gleason病理评分、ALP、血清PSA均是影响患者术后发生骨转移的危险因素(P<0.05)。ROC曲线分析显示,血清PSA、ADC熵、T_(2)WI熵及三者联合预测前列腺癌根治术后发生骨转移风险的AUC分别为0.858、0.734、0.576、0.925,三指标联合预测效能高于单项检测(P<0.05)。结论高水平ADC熵、T_(2)WI熵及血清PSA是影响前列腺癌患者术后发生骨转移的危险因素,三者联合对患者术后发生骨转移具有较高的预测价值。Objective To investigate the relationship between serum prostate specific antigen(PSA)and postoperative bone metastases based on the texture analysis of two-parameter magnetic resonance imaging(bpMRI)based on the primary lesions of prostate cancer.Methods 134 patients with prostate cancer admitted to our hospital from January 2019 to January 2022 were selected.The patients were admitted to hospital for bpMRI and serum PSA examination,and underwent laparoscopic radical prostatectomy.The patients were followed up for 1 year.According to the postoperative bone metastasis,the patients were divided into metastatic group(n=62)and non-metastatic group(n=66).Logistic regression model was used to analyze the risk factors.The predictive value was evaluated using receiver operating characteristic curve(ROC).Results There was no significant difference in apparent diffusion coefficient(ADC)kurtosis,ADC skewness,T_(2)WI kurtosis,T_(2)WI skewness between 2 groups(P>0.05).ADC entropy and T_(2)WI entropy in metastatic group were higher than those in non-metastatic group(P<0.05).There was no significant difference in age,clinical stage,hypertension,diabetes and tumor diameter between 2 groups(P>0.05).The Gleason pathological score,alkaline phosphatase(ALP)and serum PSA levels in the metastatic group were higher than those in the non-metastatic group,while the hemoglobin(Hb)level in the metastatic group was lower than that in the non-metastatic group(P<0.05).Multivariate Logistic regression analysis showed that high ADC entropy,T_(2)WI entropy,Gleason pathological score,ALP and serum PSA were all risk factors for postoperative bone metastasis(P<0.05).ROC curve analysis showed that the AUCs of serum PSA,ADC entropy,T_(2)WI entropy and their combination in predicting the risk of bone metastasis after radical prostate cancer surgery were 0.858,0.734,0.576 and 0.925,respectively,and the combined predictive efficacy of the three indexes was higher than that of single test(P<0.05).Conclusion High levels of ADC entropy,T2-WI entropy and s

关 键 词：前列腺癌 双参数磁共振成像纹理分析 血清PSA 骨转移 

分 类 号：R737.25[医药卫生—肿瘤]