动态增强磁共振成像联合血清游离前列腺特异性抗原检测对前列腺癌的诊断价值  

Diagnostic Value of Dynamic Enhanced Magnetic Resonance Imaging Combined with Detection of Serum Free Prostate-specific Antigen Level in Prostate Cancer

作　　者：丁云云 张继良[2] 武东杰 DING Yunyun;ZHANG Jiliang;WU Dongjie(Department of Medical Imaging,Jinshui District General Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市金水区总医院医学影像科,河南郑州450000 [2]河南省人民医院医学影像科,河南郑州450000 [3]郑州市金水区总医院全科医学科与肿瘤科,河南郑州450000

出　　处：《航空航天医学杂志》2024年第9期1041-1044,共4页Journal of Aerospace medicine

摘　　要：目的 探究动态增强磁共振成像(Dynamic contrast-enhanced-MRI,DCE-MRI)联合血清游离前列腺特异性抗原(Free prostate-specific antigen, fPSA)检测在前列腺癌中的诊断价值。方法 收集2019年01月-2023年11月于郑州市金水区总医院就诊的60例疑似前列腺癌患者,同期选取60例体检健康者作为健康组,根据手术或病理活检结果,将60例疑似前列腺癌患者分为前列腺癌组(28例)、良性组(32例),分析前列腺癌患者DCE-MRI声像图特征,比较3组DCE-MRI定量参数、血清fPSA水平,比较不同分化程度患者入院时DCE-MRI定量参数、血清fPSA水平,采用Pearson法分析相关性,通过ROC曲线分析联合诊断价值。结果 三组入院时速率常数(Rate constant, Kep)、容积运转常数(Volume operation constant, Ktans)及血管外细胞外容积分数(Extravascular extracellular volume fraction, Ve)值及血清fPSA水平比较:前列腺癌组>良性组>健康组(P<0.05);低、中分化癌患者入院时Ve、Ktrans、Kep及血清fPSA水平高于高分化癌者(P<0.05);入院时Ve、Ktrans、Kep及血清fPSA水平均与Gleason评分呈正相关(P<0.05);入院时Ve、Ktrans、Kep、血清fPSA水平单独及联合诊断前列腺癌的AUC均>0.6,但各指标联合诊断前列腺癌的AUC最高(P<0.05)。结论 DCE-MRI、血清fPSA水平联合诊断在前列腺癌中诊断敏感度、特异度均高于单独诊断,可为临床诊断前列腺癌提供可靠依据。Objective To explore the diagnostic value of dynamic enhanced magnetic resonance imaging(DCE-MRI)combined with serum free prostate-specific antigen(fPSA)in prostate cancer.Methods A about 60 patients with suspected prostate cancer who were treated in Zhengzhou Jinshui District General Hospital from January 2019 to November 2023 were collected,and 60 healthy subjects were selected as the healthy group during the same period.According to the results of surgery or pathological biopsy,60 suspected prostate cancer patients were divided into prostate cancer group(28 cases)and benign group(32 cases).DCE-MRI quantitative parameters and serum fPSA levels were compared among the three groups,DCE-MRI quantitative parameters and serum fPSA levels were compared when patients with different differentiation degrees were admited to hospital,correlation was analyzed by Pearson method,and combined diagnostic value was analyzed by ROC curve.Results Rate constant(Kep),volume operation constant(Ktans),Extravascular extracellular volume fraction fraction(Ve)and serum fPSA levels were compared among the three groups at admission:prostate cancer group>benign group>healthy group(P<0.05);The levels of Ve,Ktrans,Kep and fPSA in patients with low and medium-differentiated carcinoma were higher than those in patients with highly differentiated carcinoma(P<0.05).The levels of Ve,Ktrans,Kep and fPSA were positively correlated with Gleason score(P<0.05).At admission,the AUC of Ve,Ktrans,Kep and serum fPSA levels were all higher than O.6,but the AUC of the combined diagnosis of prostate cancer was the highest(P<0.05).Conclusions The sensitivity and specificity of combined diagnosis of DCE-MRI and serum fPSA are higher than that of single diagnosis in prostate cancer,which can provide a reliable basis for clinical diagnosis of prostate cancer.

关 键 词：动态增强核磁共振成像 游离前列腺特异性抗原 前列腺癌 

分 类 号：R737.25[医药卫生—肿瘤]