| 古志聪,陈南辉,杨日辉,范伟雄,朱文标,张添辉.前列腺PI-RADS V2.1评分联合血清PSA相关指标对灰区前列腺癌的诊断价值研究[J].,2021,(7):1387-1390 |
| 前列腺PI-RADS V2.1评分联合血清PSA相关指标对灰区前列腺癌的诊断价值研究 |
| Diagnostic Value of PI-RADS V2.1 Score Combined with Serum PSA Related Indicators in Gray Zone Prostate Cancer |
| 投稿时间：2020-09-21 修订日期：2020-10-16 |
| DOI：10.13241/j.cnki.pmb.2021.07.041 |
| 中文关键词: 前列腺癌 前列腺特异抗原 磁共振成像 前列腺影像报告与数据系统 诊断价值 |
| 英文关键词: Prostate cancer Prostate specific antigen Magnetic resonance imaging Prostate imaging report and data system Diagnostic value |
| 基金项目:广东省自然科学基金-面上项目（2020A1515010015） |
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| 中文摘要: |
| 摘要 目的：探讨前列腺影像报告和数据系统第2.1版（PI-RADS V2.1）评分联合血清前列腺特异抗原（PSA）相关指标对灰区前列腺癌的诊断价值。方法：回顾性分析2016年1月至2019年12月的187例经病理证实且PSA为灰区（4-10 ng/mL）的前列腺癌或前列腺增生患者资料。根据病理结果分为前列腺癌（PCa）组与前列腺增生组（BPH）组。由两名经验丰富的MRI诊断医师通过盲法对所有患者MRI图像进行PI-RADS V2.1评分，统计并计算血清PSA相关指标：总前列腺特异抗原（t-PSA）、游离前列腺特异抗原（f-PSA）、游离前列腺特异抗原与总前列腺特异抗原比值（f-PSA/t-PSA）、前列腺特异抗原密度（PSAD）。采用t检验比较各项指标在两组间的差异性，并使用受试者工作曲线（ROC）分析各项指标对灰区前列腺癌的诊断效能。结果：PI-RADS V2.1评分与PSAD在PCa与BPH组之间的差异具有统计学意义（P＜0.05），而t-PSA、f-PSA、f-PSA/t-PSA在PCa与BPH组之间的差异均无统计学意义（P＞0.05）。根据ROC曲线分析，PI-RADS V2.1评分、PSAD、PI-RADS V2.1评分联合PSAD诊断灰区前列腺癌的曲线下面积（AUC）分别为0.814、0.671及0.838，且PI-RADS V2.1评分联合PSAD的AUC显著高于单独应用PI-RADS V2.1评分（Z=1.989，P＜0.05）与PSAD（Z=3.174，P＜0.05）。结论：PI-RADS V2.1评分与PSAD对诊断灰区前列腺癌具有较高诊断效能，且联合PI-RADS V2.1评分与PSAD能进一步提高诊断效能。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the diagnostic value of prostate imaging report and data system version 2.1 (PI-RADS V2.1) score combined with serum prostate specific antigen (PSA) related indicators in the diagnosis of gray zone prostate cancer. Methods: the data of 187 patients with prostate cancer or benign prostatic hyperplasia confirmed by pathology and whose PSA was gray zone (4-10 ng/mL) from January 2016 to December 2019 were analyzed retrospectively. According to the pathological results, the patients were divided into two groups: prostate cancer (PCa) group and benign prostatic hyperplasia (BPH) group. Two experienced MRI diagnostic physicians blindly scored MRI images of all patients with PI-RADS V2.1, and calculated the related indexes of serum PSA: total prostate specific antigen (t-PSA), free prostate specific antigen (f-PSA), ratio of free prostate specific antigen to total prostate specific antigen (f-PSA/t-PSA), and prostate specific antigen density (PSAD). T-test was used to compare the differences of each index between the two groups, and the receiver operating characteristic curve (ROC) was used to analyze the diagnostic efficacy of each index in the diagnosis of PCa in the gray zone. Results: There was significant difference in PI-RADS V2.1 score and PSAD between PCa and BPH group, but there was no significant difference in t-PSA, f-PSA and f-PSA/t-PSA between PCa and BPH group. According to the ROC curve analysis, the area under the curve (AUC) of PI-RADS V2.1, PSAD and PI-RADS V2.1 combined with PSAD in the diagnosis of PCa were 0.814, 0.671 and 0.838, respectively, and the AUC of PI-RADS V2.1 combined with PSAD was significantly higher than that of PI-RADS V2.1 alone (Z= 1.989, P < 0.05) and PSAD (Z=3.174, P < 0.05). Conclusion: PI-RADS V2.1 score and PSAD have higher diagnostic efficacy in the diagnosis of gray zone prostate cancer, and the combination of PI-RADS V2.1 score and PSAD can improve the diagnostic efficiency. |
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