血清PSA水平与MRI相关参数对老年前列腺良恶性病变的诊断价值  

Diagnostic Value of Serum PSA Levels Combined with MRI Parameters in Elderly Prostate Benign and Malignant Lesions

作　　者：安宁 何宏艳 程佳琪 程晓露 赵增喜[1] 张瑞[1] AN Ning;HE Hong-yan;CHENG Jia-qi;CHENG Xiao-lu;ZHAO Zeng-xi;ZHANG Rui(Department of Urology,The Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China;Department of Oncology,The Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China;Department of Anesthesiology,The Second Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075100,China)

机构地区：[1]河北北方学院附属第二医院泌尿外科,河北张家口075100 [2]河北北方学院附属第二医院肿瘤科,河北张家口075100 [3]河北北方学院附属第二医院麻醉科,河北张家口075100

出　　处：《河北北方学院学报(自然科学版)》2025年第2期31-34,38,共5页Journal of Hebei North University:Natural Science Edition

摘　　要：目的探讨血清PSA水平与MRI相关参数对老年前列腺良恶性病变的诊断价值。方法选取90例老年前列腺癌患者为观察组,同期90例老年前列腺良性增生患者为对照组。均给予MR扩散加权成像检查,测量其相应的表观扩散系数(apparent diffusion coefficient,ADC),计算ADCmean及相对平均ADC值(relative ADC_(mean),rADCmean)。应用酶联免疫吸附法检测血清PSA水平。收集患者人口学资料、体格检查资料、家族史、个人史及临床资料等,采用单因素及多因素Logistic回归模型分析影响前列腺病变良恶性诊断的独立影响因素;采用受试者工作特征曲线评估不同的预测模型对前列腺癌的诊断效能。结果2组患者血清PSA水平、ADCmean及rADCmean组间差异有统计学意义(P<0.05)。血清PSA水平、ADCmean及rADCmean是老年前列腺恶性肿瘤的独立影响因素;血清PSA的AUC为0.848(0.786~0.910),ADCmean的AUC为0.747(0.676~0.817),rADCmean的AUC为0.788(0.721~0.854),血清PSA联合ADCmean及rADCmean的AUC为0.929(0.893~0.966)。结论血清PSA联合MRI相关参数可显著提高对老年前列腺良恶性病变的诊断效能,对临床上早期区分前列腺良恶性肿瘤具有重要的参考价值。Objective To investigate the diagnostic value of serum PSA level and MRI-related parameters in benign and malignant prostate lesions in the elderly.Methods A total of 90 elderly patients with prostate cancer as the observation group,and 90 elderly patients with benign prostatic hyperplasia as the control group were examined by MR diffusion-weighted imaging,and the corresponding apparent diffusion coefficient(ADC)values were measured.The ADCmean and relative ADC(rADCmean)were calculated.Serum PSA level was detected by enzyme-linked immunosorbent assay.The demographic data,physical examination data,family history,personal history and clinical data of the patients were collected.Univariate and multivariate Logistic regression models were used to analyze the independent influencing factors affecting the diagnosis of benign and malignant prostates.The receiver operating characteristic curve was used to evaluate the diagnostic efficacy of different prediction models for prostate cancer.Results There were significant differences in serum PSA level,ADCmean and rADCmean between the two groups(P<0.05).Serum PSA level,ADCmean and rADCmean were independent influencing factors of prostate malignant tumors in the elderly.The AUC of serum PSA was 0.848(0.786~0.910),the AUC of ADCmean was 0.747(0.676~0.817),the AUC of rADCmean was 0.788(0.721~0.854),the AUC of serum PSA combined with ADCmean and rADCmean was 0.929(0.893~0.966).Conclusion Serum PSA combined with MRI-related parameters can significantly improve the diagnostic efficacy of benign and malignant prostate lesions in the elderly,and has important reference value for early clinical differentiation of benign and malignant prostate tumors.

关 键 词：血清PSA 表观扩散系数 相对平均表观扩散系数 前列腺良恶性病变 老年 

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