TRUS/MR靶向穿刺联合FPSA、D-D、睾酮在前列腺癌诊断中的应用价值  

Application value of TRUS/MR targeted puncture combined with FPSA,D-D and testosterone in the diagnosis of prostate cancer

作　　者：魏雪峰[1] 陈建军[1] 张志杰[1] 卢冬敏[2] 赵景良[1] 王彩军[1] 马磊 Wei Xuefeng;Chen Jianjun;Zhang Zhijie;Lu Dongmin;Zhao Jingliang;Wang Caijun;Ma Lei(Department of Urology,the Second Hospital of Qinhuangdao,Qinhuangdao 066600,China;Department of Ultrasound,the Second Hospital of Qinhuangdao,Qinhuangdao 066600,China)

机构地区：[1]秦皇岛市第二医院泌尿外科,秦皇岛066600 [2]秦皇岛市第二医院超声科,秦皇岛066600

出　　处：《国际泌尿系统杂志》2024年第6期968-972,共5页International Journal of Urology and Nephrology

基　　金：秦皇岛市科学技术研究与发展计划(201902A097)。

摘　　要：目的探讨经直肠超声(TRUS)/磁共振成像(MR)靶向穿刺联合游离型前列腺特异抗原(FPSA)、D-二聚体(D-D)、睾酮在前列腺癌(PCa)诊断中的应用价值。方法选择2020年1月至2022年12月在本院诊断的62例PCa患者作为PCa组,选择同期在本院诊断的62例良性前列腺增生(BPH)患者作为BPH组。PCa组行TRUS/MR靶向穿刺,两组均行血清FPSA、D-D、睾酮检测。观察两组患者的血清FPSA、D-D、睾酮水平,分析PCa组中不同分型患者的血清FPSA、D-D、睾酮水平。以术后病理为金标准,分析TRUS/MR靶向穿刺及血清FPSA、D-D、睾酮单独及联合诊断PCa的诊断效能。分析PCa患者的Gleason评分与TRUS/MR靶向穿刺及血清FPSA、D-D、睾酮的相关性。结果PCa组的血清FPSA、D-D水平高于BPH组,血清睾酮水平低于BPH组(均P<0.001)。低危型PCa患者的血清FPSA、D-D水平低于中危型、高危型PCa患者,血清睾酮水平高于中危型、高危型PCa患者(均P<0.05)。中危型PCa患者的血清FPSA、D-D水平低于高危型PCa患者,血清睾酮水平高于高危型PCa患者(均P<0.001)。TRUS/MR靶向穿刺联合FPSA、D-D、睾酮诊断PCa的灵敏度、特异度、阳性预测值及阴性预测值均高于其单独及联合诊断(均P<0.05)。Pearson相关分析结果显示,Gleason评分与TRUS/MR靶向穿刺、血清FPSA水平无相关性(r=0.127、0.151,均P>0.05),而与D-D水平呈正相关,与血清睾酮水平呈负相关(r=0.526、-0.461,均P<0.05)。多因素Cox回归分析结果显示,FPSA≥6.83 ng/mL、D-D≥0.71 mg/L、睾酮≤0.20μg/L为PCa的独立危险因素(均P<0.05)。结论PCa患者的血清FPSA、D-D、睾酮水平均具有异常改变,TRUS/MR靶向穿刺联合FPSA、D-D、睾酮对PCa具有较高的诊断效能。Objective To investigate the value of transrectal ultrasound(TRUS)/magnetic resonance imaging(MR)targeted puncture combined with free prostatespecific antigen(FPSA),D-dimer(D-D)and testosterone in the diagnosis of prostate cancer(PCa).Methods From January 2020 to December 2022,62 patients with PCa diagnosed in our hospital were selected as the PCa group,and 62 patients with benign prostatic hyperplasia(BPH)diagnosed in our hospital during the same period were selected as the BPH group.TRUS/MR targeted puncture was performed in PCa group,and serum FPSA,D-D and testosterone were detected in both groups.The serum levels of FPSA,D-D and testosterone in two groups were observed,and the serum levels of FPSA,D-D and testosterone in different types of patients in PCa group were analyzed.Using postoperative pathology as the gold standard,the diagnostic efficacy of TRUS/MR targeted puncture and serum FPSA,D-D,testosterone alone and in combination with PCa was analyzed.The correlation between Gleason score and TRUS/MR targeted puncture,serum FPSA,D-D and testosterone in PCa patients was analyzed.Results The serum FPSA and D-D levels in PCa group were higher than those in BPH group,and serum testosterone levels were lower than those in BPH group(all P<0.001).The serum levels of FPSA and D-D in low-risk PCa patients were lower than those in medium-risk and high-risk PCa patients,and the serum levels of testosterone were higher than those in medium-risk and high-risk PCa patients(all P<0.05).The serum levels of FPSA and D-D in medium-risk PCa patients were lower than those in high-risk PCa patients,and the serum levels of testosterone were higher than those in high-risk PCa patients(all P<0.001).The sensitivity,specificity,positive predictive value and negative predictive value of TRUS/MR targeted puncture combined with FPSA,D-D and testosterone in the diagnosis of PCa were higher than those in the single and combined diagnosis(all P<0.05).Pearson correlation analysis showed that Gleason score was not correlated with TRUS/MR t

关 键 词：前列腺肿瘤 超声检查 磁共振成像 游离前列腺特异抗原 D-二聚体 

分 类 号：R737.25[医药卫生—肿瘤]