前列腺影像报告与数据系统对前列腺特异性抗原灰区前列腺癌的诊断价值

发布时间：2018-04-19 03:27

  本文选题：前列腺增生 + 前列腺肿瘤　； 参考：《重庆医学》2017年22期

【摘要】：目的评估前列腺影像报告与数据系统(PIRADS v2)对前列腺特异性抗原(PSA)灰区前列腺癌(PCa)的诊断价值。方法纳入2012-2016年总共2 200例行前列腺磁共振成像(MRI)检查病例中PSA为4~10ng/mL,穿刺活检或手术切除前行多参数MRI(mp-MRI)检查,未接受任何形式治疗的PCa及前列腺增生(BPH)患者,收集mp-MRI图像及临床资料,回顾性分析其mp-MRI,根据PIRADS v2对所有病灶定量评分,记录PIRADS v2分值及病灶所在区域。以经直肠超声(TRUS)引导穿刺活检或手术切除标本病理结果为金标准。运用ROC曲线计算PIRADS v2诊断PSA灰区PCa的诊断价值,Logistic回归分析前列腺癌的危险因素。结果共纳入15例PCa患者和30例BPH患者,两组患者在年龄、tPSA、fPSA、f/tPSA、前列腺体积、PSA密度(PSAD)差异均无统计学意义(P0.05)。PIRADS v2诊断PCa的曲线下面积(AUC)=0.932(95%CI 0.822~0.984),P0.01;最佳切点为PIRADS v2≥4分,诊断敏感性为88.89%,特异性为87.10%,阳性预测值为80.00%,阴性预测值为93.10%。Logistic回归显示,PIRADS v2评分是PCa的独立预测因子,Hazard Ratio(HR)=17.847(3.745~85.078),P0.01。PIRADS v2评分与病理Gleason评分呈正相关(r=0.585,P=0.022)。结论 PIRADS v2评分对PSA灰区PCa具有较高的诊断价值,且与病理结果具有相关性。
[Abstract]:Objective to evaluate the diagnostic value of prostate imaging report and data system (PIRADS v2) for prostate cancer (PCA) in the gray area of prostate specific antigen (PSA).Methods A total of 2 200 patients with prostatic magnetic resonance imaging (PSA) from 2012 to 2016 were enrolled in this study. PSA was 4ng / mL. MRImp-MRI was performed with multiple parameters before puncture biopsy or surgical resection. Patients with PCa and benign prostatic hyperplasia (BPH) who did not receive any form of treatment were enrolled in this study.Mp-MRI images and clinical data were collected and mp-MRI was analyzed retrospectively. According to the quantitative score of PIRADS v2, the score of PIRADS v2 and the location of the lesion were recorded.The results of transrectal ultrasound trust guided biopsy or surgical resection were regarded as gold standard.ROC curve was used to calculate the diagnostic value of PIRADS v2 in the diagnosis of PCa in PSA grey area. Logistic regression analysis was used to analyze the risk factors of prostate cancer.Results there were 15 patients with PCa and 30 patients with BPH. There was no significant difference in the area under the curve between the two groups in the diagnosis of PCa. The best cut point was PIRADS v2 鈮，

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