动态对比增强磁共振成像联合血清分泌型磷酸蛋白1和铜蓝蛋白检测在早期前列腺癌和前列腺炎中的鉴别诊断价值  

The diagnostic value of dynamic contrast-enhanced MRI combined with serum secretory phosphoprotein 1 and ceruloplasmin in differentiating early prostate cancer from prostatitis

作　　者：龚林建 吉莉 顾春华[1] Gong Linjian;Ji Li;Gu Chunhua(Department of Radiology,Nantong Traditional Chinese Medicine Hospital,Nantong 226001,China)

机构地区：[1]南通市中医院放射科,南通226001

出　　处：《中国肿瘤临床与康复》2024年第10期610-615,共6页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨动态对比增强磁共振成像(DCE-MRI)联合血清分泌型磷酸蛋白1(SPP1)和铜蓝蛋白(CP)检测在早期前列腺癌与前列腺炎鉴别诊断中的价值。方法回顾性分析2020年2月至2023年12月于南通市中医院诊断治疗的133例早期前列腺癌和前列腺炎患者资料,其中通过临床病理诊断确认的早期前列腺癌(Gleason评分≤7)患者68例,设为肿瘤组;前列腺炎患者65例,设为炎症组。所有患者均进行DCE-MRI检查以及血清SPP1和CP水平的测定。根据生物标志物水平及DCE-MRI检查结果与最终病理诊断对比,探讨其在前列腺癌与前列腺炎鉴别诊断中的价值。通过受试者工作特征曲线(ROC)分析,评估DCEMRI参数及血清SPP1和CP水平对前列腺癌和前列腺炎的鉴别诊断价值。结果肿瘤组和炎症组患者DCE-MRI的容积转运常数(K^(trans))分别为(0.17±0.07)/min和(0.10±0.04)/min,肿瘤组明显高于炎症组(P<0.001)。肿瘤组和炎症组患者血清SPP1水平分别为(86.60±34.48)ng/ml和(65.37±27.79)ng/ml,肿瘤组明显高于炎症组(P<0.001);肿瘤组和炎症组患者血清CP水平分别为(35.17±9.84)mg/ml和(29.77±7.20)mg/ml,肿瘤组明显高于炎症组(P<0.001)。SPP1和CP预测早期前列腺癌的灵敏度均为54.4%,特异度均为80.0%,曲线下面积(AUC)分别为0.693和0.684。而K^(trans)预测早期前列腺癌的灵敏度为58.8%,特异度为90.8%,AUC为0.799。当SPP1、CP和K^(trans)联合时,预测早期前列腺癌的灵敏度提升至64.7%,特异度提高至96.9%,AUC达到0.856。结论DCE-MRI联合血清SPP1和CP水平的测定在鉴别诊断早期前列腺癌与前列腺炎方面显示出较高的诊断效能,可明显提高诊断的灵敏度和特异度,为临床提供了一种有效的前列腺病变鉴别工具。Objective To investigate the effectiveness of dynamic contrastenhanced magnetic resonance imaging(DCE-MRI)combined with serumsecreted phosphoprotein 1(SPP1)and ceruloplasmin(CP)in the differential diagnosis of early prostate cancer and prostatitis.Methods A retrospective study was conducted,including 133 patients diagnosed and treated for early prostate cancer and prostatitis at Nantong Hospital of Traditional Chinese Medicine from February 2020 to December 2023.Among them,68 were diagnosed with early prostate cancer(Gleason score≤7)and set as the tumor group while 65 patients had prostatitis and were set as the inflammation group.All patients underwent DCE-MRI and serum SPP1 and CP level measurements.The diagnostic value of these biomarkers and DCE-MRI results was compared with the final pathological diagnosis.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic value of DCE-MRI parameters and serum SPP1 and CP levels in differentiating prostate cancer from prostatitis.Results The volume transfer constant(K^(trans))of DCEMRI in the tumor group was(0.17±0.07)/min,significantly higher than(0.10±0.04)/min in the inflammation group(P<0.001).Serum SPP1 levels in the tumor and inflammation groups were(86.60±34.48)ng/ml and(65.37±27.79)ng/ml,respectively,with the tumor group significantly higher(P<0.001).Serum CP levels were(35.17±9.84)mg/ml in the tumor group and(29.77±7.20)mg/ml in the inflammation group,with the tumor group also significantly higher(P<0.001).The sensitivity and specificity of SPP1 and CP in predicting early prostate cancer were 54.4%and 80.0%,with areas under the curve(AUC)of 0.693and 0.684,respectively.K^(trans)had a sensitivity of 58.8%,specificity of 90.8%,and AUC of 0.799 for predicting early prostate cancer.When combined,SPP1,CP,and K^(trans)improved the sensitivity to 64.7%,specificity to 96.9%,and AUC to 0.856.Conclusion The combination of DCE-MRI and the measurement of serum SPP1 and CP levels demonstrates high diagnostic efficacy in differentiating early

关 键 词：前列腺肿瘤 前列腺炎 动态对比增强磁共振成像 分泌型磷酸蛋白1 铜蓝蛋白 

分 类 号：R737.25[医药卫生—肿瘤] R445.2[医药卫生—临床医学] R697.33