摘要
目的 探讨前列腺影像报告和数据系统(PI-RADS) v2.1联合前列腺特异性抗原(PSA)相关参数对临床显著性前列腺癌的诊断效能,并进行内部验证。方法 收集2016年1月至2021年4月北部战区总医院放射诊断科150例活检前接受前列腺磁共振检查且总前列腺特异抗原(tPSA)>4 ng/mL患者的临床资料。Gleason评分≥7分患者纳入临床显著性前列腺癌(csPCa)组(n=71),Gleason评分<7分及良性疾病(前列腺增生、前列腺炎)患者纳入非csPCa组(n=79)。从2组中按7∶3比例随机分配至建模组和验证组。采用t检验比较2组PI-RADS v2.1、tPSA、游离PSA/tPSA (f/tPSA),PSA密度(PSAD)的差异,将有统计学差异(P <0.05)指标作为自变量,建立PI-RADS v2.1与PSA相关参数的logistic预测模型:(1) PI-RADS v2.1+tPSA;(2) PI-RADS v2.1+t/f PSA;(3) PI-RADS v2.1+PSAD。将验证组数据代入模型方程,以预测概率(P)及PI-RADS v2.1绘制受试者操作特征(ROC)曲线,评估诊断效能。结果 PI-RADS v2.1与PSA相关参数建立预测模型:(1) Logit P=-7.313+1.62PI-RADS v2.1+0.088tPSA;(2) Logit P=-0.453+1.833PI-RADS v2.1-39.811f/tPSA;(3) Logit P=-12.031+1.917PI-RADS v2.1+29.206PSAD。模型(1)、(2)、(3)的预测概率(P)与PI-RADS v2.1的ROC曲线下面积分别为0.927、0.915、0.984和0.899;Z检验进行两两比较结果显示,模型(1)、(2)与PIRADS v2.1诊断csPCa比较差异无统计学意义(均P> 0.05);模型(3)与PI-RADS v2.1诊断csPCa的差异有统计学意义(P <0.05)。结论 PI-RADS v2.1与PSAD联合诊断的预测模型对csPCa的诊断效能高于PI-RADS v2.1单独诊断。
Objective To evaluate the diagnostic efficacy of PI-RADS v2.1 combined with prostate-specific antigen(PSA)-related parameters for clinically significant prostate cancer(csPCa) and to perform an internal validation. Methods The clinical data of 150patients who underwent prostate magnetic resonance before biopsy and had total prostate-specific antigen(tPSA) >4 ng/mL were evaluated from January 2016 to April 2021 at the Department of Diagnostic Radiology,Northern War Zone General Hospital. Patients with a Gleason score of ≥7 were included in the csPCa group(n = 71),and patients with a Gleason score of<7 and patients with benign disease(prostatic hyperplasia or prostatitis) were included in the non-csPCa group(n = 79). The two groups were randomly assigned to the modeling and validation groups in a 7 ∶ 3 ratio. t test was used to compare the differences in PI-RADS v2.1,tPSA,free PSA/total PSA(f/tPSA),and PSA density(PSAD) between the two groups,and statistically different(P < 0.05) indicators were used as independent variables to establish a logistic prediction model of PI-RADS v2.1 and PSA-related parameters:(1) PI-RADS v2.1+tPSA;(2) PI-RADS v2.1+t/fPSA;and(3) PI-RADS v2.1+PSAD. Data from the validation group were substituted into the model equation,and the receiver operating characteristic(ROC) curves were plotted with predicted probability(P) and PI-RADS v2.1 to assess the diagnostic efficacy.Results PI-RADS v2.1 was modeled with PSA-related parameters to predict(1) Logit P =-7.313+1.62PI-RADS v2.1+0.088tPSA;(2) Logit P =-0.453+1.833PI-RADS v2.1-39.811f/tPSA;and(3) Logit P =-12.031+1.917PI-RADS v2.1+29.206PSAD. The area under the ROC curves of the predicted probabilities P of models(1),(2),and(3) with PI-RADS v2.1 was 0.927,0.915,0.984,and 0.899,respectively,and the results of the two-way comparisons performed by Z test showed that models(1),(2),and PI-RADS v2.1 were not statistically significant(all P > 0.05). The differences between model(3) and PI-RADS v2.1 for the diagnosis of csPCa were statistically sign
作者
钟宇
田芳
周姝
邹明宇
张立波
刘文源
ZHONG Yu;TIAN Fang;ZHOU Shu;ZOU Mingyu;ZHANG Libo;LIU Wenyuan(Department of Diagnostic Radiology,Northern War Zone General Hospital,Shenyang 110016,China)
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2022年第12期1090-1094,1101,共6页
Journal of China Medical University
基金
辽宁省自然科学基金(201602781)。
