前列腺磁共振波谱成像联合血清ANXA2、PKM2鉴别诊断前列腺癌的临床价值  

The clinical value of prostate magnetic resonance spectroscopy combined with serum annexin A2 and pyruvate kinase M2 in the differential diagnosis of prostate cancer

作　　者：刘平安 谭凡 陈文[1] LIU Ping′an;TAN Fan;CHEN Wen(Medical Imaging Center,Taihe Hospital,Shiyan 442000,Hubei,China;Department of Nuclear Medicine,Taihe Hospital,Shiyan 442000,Hubei,China)

机构地区：[1]湖北省十堰市太和医院医学影像中心,湖北十堰442000 [2]湖北省十堰市太和医院核医学科,湖北十堰442000

出　　处：《中国性科学》2024年第11期36-40,共5页Chinese Journal of Human Sexuality

基　　金：2019年度十堰市太和医院院级基金项目(2019JJXM047)。

摘　　要：目的探究前列腺磁共振波谱成像(MRS)联合血清膜联蛋白A2(ANXA2)、丙酮酸激酶M2型(PKM2)对前列腺癌的鉴别诊断价值。方法选取2021年2月至2023年2月湖北省十堰市太和医院诊治的86例前列腺癌患者(前列腺癌组)及86例前列腺增生患者(前列腺增生组)作为研究对象。两组均进行前列腺MRS检查;采用酶联免疫吸附试验法检测两组血清ANXA2、PKM2水平;比较两组胆碱/枸橼酸盐(Cho/Cit)值、(肌酸+胆碱)/枸橼酸盐(CC/C)值,以及血清ANXA2、PKM2水平;分析MRS、血清ANXA2、PKM2单独及三者联合对前列腺癌的鉴别诊断效能。结果前列腺癌组Cho/Cit值、CC/C值及血清ANXA2、PKM2水平均显著高于前列腺增生组(P<0.05);以病理检查结果为金标准,MRS的灵敏度、特异度及准确度分别为84.88%、80.23%、82.56%,与金标准具有较高的一致性(Kappa=0.651,P<0.05);受试者工作特征(ROC)曲线结果显示,血清ANXA2、PKM2诊断前列腺癌的灵敏度分别为81.40%、77.90%,特异度分别为72.11%、67.44%,两者与金标准均具有较高的一致性(Kappa=0.535、0.453,P<0.05);MRS联合血清ANXA2、PKM2鉴别诊断前列腺癌的曲线下面积(AUC)为0.934,灵敏度为90.70%,特异度为77.91%,均显著高于三者单独检测(P<0.05)。结论前列腺MRS联合血清ANXA2、PKM2鉴别诊断前列腺癌具有较高的临床价值,可用于辅助临床诊断前列腺癌。Objective To explore the differential diagnostic value of prostate magnetic resonance spectroscopy(MRS)combined with serum annexin A2(ANXA2)and pyruvate kinase M2(PKM2)in prostate cancer.Methods A total of 86 patients with prostate cancer(prostate cancer group)and 86 patients with prostate hyperplasia(prostate hyperplasia group)admitted to Taihe Hospital from February 2021 to February 2023 were selected as the research objects.Both groups underwent prostate MRS examination.Enzyme-linked immunosorbent assay was applied to measure the serum levels of ANXA2 and PKM2 in the two groups.The choline/citrate(Cho/Cit)values,(creatine+choline)/citrate(CC/C)values,and serum ANXA2 and PKM2 levels of both groups were compared.The differential diagnostic efficacy of MRS,serum ANXA2,PKM2 alone and their combination for prostate cancer was analyzed.Results The Cho/Cit values,CC/C values,serum ANXA2 and PKM2 levels in the prostate cancer group were significantly higher than those in the prostate hyperplasia group(P<0.05).Pathological examination results were set as the gold standard,the sensitivity,specificity and accuracy of MRS were 84.88%,80.23%and 82.56%,respectively,which were highly consistent with the gold standard(Kappa=0.651,P<0.05).The receiver operating characteristic(ROC)curve results showed that the sensitivity of serum ANXA2 and PKM2 in the diagnosis of prostate cancer was 81.40%and 77.90%respectively,and the specificity was 72.11%and 67.44%,respectively,both of which showed high consistency with the gold standard(Kappa=0.535,0.453,P<0.05).The area under the curve(AUC)of MRS combined with serum ANXA2 and PKM2 for differential diagnosis of prostate cancer was 0.934,with a sensitivity of 90.70%and a specificity of 77.91%,all of which were significantly higher than those detected alone(P<0.05).Conclusions Prostate MRS combined with serum ANXA2 and PKM2 has high clinical value in the differential diagnosis of prostate cancer,and can be used as an auxiliary clinical diagnosis for prostate cancer.

关 键 词：磁共振波谱成像 膜联蛋白A2 丙酮酸激酶M2型 前列腺癌 鉴别诊断 

分 类 号：R697[医药卫生—泌尿科学]