摘要
目的:探究前列腺影像报告和数据系统(PIRADS v2)在前列腺特异性抗原(PSA)4~20 ng/mL区段中诊断前列腺癌(PCa)的价值。方法:选择2018~2019年我院前列腺穿刺活检患者中PSA 4~20 ng/mL且行mp-MRI及PIRADS评分的患者255例,分为70前列腺癌(PCa)患者和185例良性前列腺增生(BPH)患者两组,收集其多参数MR(mp-MRI)图像和临床资料,回顾性分析mp-MRI,记录PIRADS v2下所有病灶的分值及病灶所在区域。以MRI经直肠超声融合(MRI-TRUS)引导下前列腺穿刺活检标本病理结果为金标准。运用Roc曲线计算PIRADS v2在PSA 4~20 ng/mL区段中的诊断价值,Logistic回归分析PCa的危险因素。结果:两组患者PIRADS v2诊断PCa的曲线下面积为0.698(95%CI 0.623~0.772),P<0.01,PIRADS v2评分4分为最佳切点,其诊断特异性为71.9%,敏感性为63.4%。Logistic回归显示,PIRADS v2评分是PCa的独立预测因子(P<0.01)。PIRADS v2评分与病理Gleason评分呈正相关(rs=0.425,P=0.00246<0.05)。结论:PIRADS v2评分在PSA 4~20 ng/mL区段中对PCa的诊断具有较高价值,其在PSA>10~20 ng/mL区段的诊断价值要高于灰区4~10 ng/mL的诊断价值,且与病理结果具有相关性。
Objective:To explore the value of prostate imaging reporting and data system(PIRADS v2)in the diagnosis of prostate cancer(PCa)in prostate specific antigen(PSA)level of 4-20 ng/mL.Method:From 2018 to 2019,255 prostatic hyperplasia(BPH)and PCa patients in our hospital with PSA level of 4-20 ng/mL were subsumed.They all received multiparametric magnetic resonance imaging(MP-MRI)with PIRADS v2 before biopsy and their MP-MRI and clinical data were collected.We retrospectively analyzed the results of mp-MRI and recorded the scores of all lesions according to PIRADS v2 and the location of the lesions.The pathological results of MRI transrectal ultrasound(MRI-TRUS)fusion guided prostate biopsy specimens were the gold reference.The diagnostic value of PIRADS v2 in PSA levels of 4-20 ng/mL was calculated by receiver operating characteristic(ROC)curve,and the risk factors of PCa were analyzed by logistic regression analysis.Result:Seventy PCa and 185 BPH patients were included.The area under ROC curve of PIRADS v2 in diagnosing PCa was 0.698(95%CI 0.623-0.772)(P<0.01)with a best cutoff PIRADS score of 4,and the diagnosis specificity was 71.9%and sensitivity 63.4%.Logistic regression shows that PIRADS v2 is an independent predictor of PCa(P<0.01).PIRADS v2 score was positively correlated to gleason score(rs=0.425,P=0.00246<0.05).Conclusion:PIRADS v2 score has high value in the diagnosis of PCa in PSA level of 4-20 ng/mL,and the diagnostic value in the PSA level of(10,20)ng/mL was significantly higher than that in the gray zone 4-10 ng/mL.PIRADS v2 score is related to pathological results.
作者
张天戈
余舟
刘迎
郭吉楠
谢京
刘增钦
黄向江
ZHANG Tiange;YU Zhou;LIU Ying;GUO Jinan;XIE Jing;LIU Zengqin;HUANG Xiangjiang(Department of Urology,Shenzhen People's Hospital,Shenzhen,Guangdong,518020,China)
出处
《临床泌尿外科杂志》
CAS
2020年第12期980-983,共4页
Journal of Clinical Urology
关键词
前列腺癌
前列腺穿刺
多参数磁共振
前列腺影像报告与数据系统v2
prostate cancer
prostate biopsy
multiparametric magnetic resonance imaging
prostate imaging reporting and data system version 2
