PI-RADS v2.1对外周带、移行带及多区域前列腺临床显著癌的诊断性能研究  

Diagnostic performance of PI-RADS v2.1 for clinically significant prostate cancer in the peripheral,transitional and multiple zones

作　　者：邓晓俊 张皓诚 张炯 钱宇航 陶玫玫 廖春梅 林妙文 郎根强 DENG Xiao-jun;ZHANG Hao-cheng;ZHANG Jiong;QIAN Yu-hang;TAO Mei-mei;LIAO Chun-mei;LIN Miao-wen;LANG Gen-qiang(Department of Urology,Hospital 411 of Shanghai University,Shanghai 200081,China;Department of Nursing,Hospital 411 of Shanghai University,Shanghai 200081,China)

机构地区：[1]上海大学附属四一一医院泌尿外科,上海200081 [2]上海大学附属四一一医院护理部,上海200081

出　　处：《中华男科学杂志》2024年第11期982-986,共5页National Journal of Andrology

基　　金：上海市虹口区卫生健康委员会医学科研课题资助项目(青年项目2403-17);上海市静安区科委、静安区卫生健康委员会医学科研课题资助项目(面上2021SM13)。

摘　　要：目的:评估前列腺影像报告和数据系统v2.1(PI-RADS v2.1)对外周带(PZ)、移行带(TZ)及多区域(MZ)的前列腺临床显著癌(CSPCa)的诊断性能。方法:回顾性研究2021年1月至2023年1月108例在我院行前列腺多参数磁共振成像(mpMRI)并行经会阴前列腺穿刺活检的临床资料,并采用PI-RADS v2.1对疑似前列腺癌(PCa)患者的MR图像进行评估和诊断,以前列腺穿刺活检的病理结果为诊断金标准并与PI-RADS v2.1诊断结果进行对照,评估PI-RADS v2.1与CSPCa的相关性。采用受试者工作特征曲线(ROC)计算曲线下面积(AUC),描述PI-RADS v2.1对PZ、TZ及MZ的CSPCa的诊断性能。结果:所有患者均顺利完成经会阴前列腺穿刺,CSPCa(GS=7~10)者66例,占61.11%。47例PZ病变中,可疑CSPCa者45例,占95.74%;17例TZ病变中,可疑CSPCa者8例,占47.06%;44例MZ病变中,可疑CSPCa者40例,占90.91%;PI-RADS v2.1对PZ、TZ及MZ病变部位诊断均与CSPCa存在显著相关性(r=0.492,P<0.001)。PI-RADS v2.1对PZ、TZ及MZ部位AUC分别为0.644、0.732及0.811;灵敏度分别为66.8%、57.6%及62.1%;灵敏度分别为57.2%、78.4%及93.2%。阴性预测值分别为46.5%、85.7%及79.2%;阳性预测值分别为76.2%、43.4%及84.8%。结论:PI-RADS v2.1评分对PZ、TZ及MZ部位CSPCa均有较好的诊断效能,其中对于MZ的诊断效能最佳。Objective:To evaluate the diagnostic performance of the Prostate Imaging Reporting and Data System version 2.1(PI-RADS v2.1)for clinically significant prostate cancer(CSPCa)in the peripheral zone(PZ),transitional zone(TZ)and multiple zones(MZs).Methods:We retrospectively studied the clinical data on 108 patients undergoing multiparametric magnetic resonance imaging(mpMRI)and transperineal prostate biopsy in our hospital from January 2021 to January 2023.Using PI-RADS v2.1,we examined the MR images of the patients with suspected PCa,compared the PI-RADS v2.1 scores with the results of prostate biopsy,and analyzed the correlation of the PI-RADS v2.1 scores with CSPCa.We calculated the area under the receiver operating characteristic(ROC)curve(AUC),and described the diagnostic performance of PI-RADS v2.1 for CSPCa in the PZ,TZ and MZs.Results:Transperineal prostate puncture biopsy was successfully completed in all the patients,which revealed 66(61.11%)cases of CSPCa with Gleason score(GS)7-10.Suspected CSPCa was observed in 45(95.74%)of the 47 PZ lesions,8(47.06%)of the 17 TZ lesions,and 40(90.91%)of the 44 MZ lesions.The PZ,TZ and MZ lesions diagnosed by PI-RADS v2.1 were significantly correlated with CSPCa(r=0.492,P<0.001).The AUCs of PI-RADS v2.1 for PZ,TZ and MZs were 0.644,0.732 and 0.811,with specificities of 66.8%,57.6%and 62.1%,and sensitivities of 57.2%,78.4%and 93.2%,respectively.The negative predictive values were 46.5%,85.7%and 79.2%,and the positive predictive values 76.2%,43.4%and 84.8%,respectively.Conclusion:The PI-RADS v2.1 score has a high diagnostic value for CSPCa in the PZ,TZ and MZs,with the best performance for that in the MZs.

关 键 词：前列腺癌 前列腺影像报告和数据系统v2.1 前列腺穿刺活检 前列腺多参数磁共振成像 

分 类 号：R737.25[医药卫生—肿瘤]