探讨前列腺特异性抗原密度(prostate-specific antigen density,PSAD)、经直肠实时组织弹性成像(transrectal real-time tissue elastography,TRTE)联合多参数磁共振成像(multiparametric magnetic resonance imaging,mpMRI)对PSA灰区可疑前列腺癌的临床价值。
方法:
收集昆山市中医医院151例PSA为4~10 ng/mL(PSA灰区)的可疑前列腺癌患者。患者均接受PSA检测、TRTE检查及mpMRI检查,比较前列腺癌组与良性增生组的年龄、PSA、TRTE评分及MRI前列腺影像报告和数据系统(Prostate Imaging Reporting and Data System,PI-RADS)评分的差异,构建受试者工作特征(receiver operating characteristic,ROC)曲线,分析单个指标(PSAD、TRTE和mpMRI)及联合诊断对PSA灰区前列腺癌的诊断效能。
结果:
两组的PSAD、TRTE评分及MRI PI-RADS评分差异均有统计学意义(
Z
=4.92、5.97、6.81,均
P
<0.001);构建PSAD、TRTE评分、MRI PI-RADS评分及三者联合诊断的ROC曲线,获得曲线下面积(area under curve,AUC)分别为0.749、0.79、0.832及0.901,三者联合诊断效能最大,且差异有统计学意义(
To investigate the clinical value of prostate-specific antigen density (PSAD)
transrectal real-time tissue elastography (TRTE) combined with multiparametric magnetic resonance imaging (mpMRI)
in the treatment of prostate cancer in the grey area of PSA.
Methods:
A total of 151 suspected prostate cancer patients with PSA of 4-10 ng/mL (PSA gray area) in Kunshan Hospital of Traditional Chinese Medicine were collected and all received PSA test
TRTE and mpMRI. The differences in age
PSA
TRTE score and MRI Prostate Imaging Reporting and Data System (PI-RADS) score between prostate cancer group and benign hyperplasia group were compared. Receiver operating characteristic (ROC) curve was constructed to analyze the diagnostic efficacy of single indicators (PSAD
TRTE score and MRI PI-RADS score) and combined diagnosis for prostate cancer in the grey area of PSA.
Results:
There were significant differences in PSAD
TRTE scores and PI-RADS scores between the two groups (
Z
=4.92
5.97
6.81
all
P
<0.001). The ROC curves of PSAD
TRTE scores
PI-RADS scores and their combined diagnosis were constructed
and the area under curve (AUC) values were 0.749
0.79
0.832 and 0.901
respectively. The combined diagnosis efficiency of the three was the highest
and the difference was statistically significant (
Z
=3.89
2.70
3.99
all
P
<0.01).
Conclusion:
PSAD
TRTE score and MRI PI-RADS score have high diagnostic value for prostate cancer in grey area of PSA. PSAD
TRTE score combined with MRI PI-RADS score can significantly improve the accuracy of prostate cancer in the grey area of PSA
and avoid many unnecessary biopsies in clinical work.
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Related Author
Anyu LI
Zheng ZHU
Qi MA
Shijie DONG
Xiaoxin HU
Xiaohang LIU
Tianwen XIE
Bingni ZHOU
Related Institution
Department of Ultrasound, Soochow University Affiliated Taicang First People's Hospital
Department of Ultrasound, The Second Affiliated Hospital of Soochow University
Department of Radiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University
Department of Radiology, Shanghai Geriatric Medical Center
Department of Radiology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University