血清前列腺特异抗原、直肠指检联合磁共振波谱成像对前列腺癌的诊断价值

摘要

目的：探讨血清前列腺特异抗原（PSA）、直肠指检（DRE）联合磁共振波谱成像（MRS）对前列腺癌的诊断价值。方法以107经超声检查发现前列腺占位或前列腺增生患者作为对象，所有患者均行血清 PSA 检查且 PSA均异常，后接受 MRS 和 DRE，根据 PSA 水平将患者分为 PSA 高危组（＞20 ng／ml）、PSA 中危组（10-20 ng／ml）、PSA低危组（4-10 ng／ml），所有患者均接受手术或穿刺活检取得病理标本，以病理诊断作为最后诊断结果，分析 MRS、DRE 对不同血清 PSA 组、MRS＋DRE 以及 MRS＋DRE＋PSA 高危对前列腺癌的诊断价值。结果107例患者病理诊断为前列腺癌的56例，非前列腺癌51例，MRS 诊断为前列腺癌57例，非前列腺50例，MRS 诊断结果与病理诊断结果一致性良好（P ＜0．05）；MRS＋ PSA 低危、RS＋ PSA 中危、MRS＋ PSA 高危诊断前列腺癌的准确性分别为70.83％、81．48％、93．75％，不同 PSA 水平组间 MRS 诊断效能不同，三种方法比较差异有统计学意义（χ2＝6．201，P＜0.05）；MRS＋DRE、MRS＋PSA 高危、MRS＋DRE＋PSA 高危诊断准确率分别为90．65％、93．75％、96．88％，均显著高于单纯 MRS 诊断的80．37％，差异有统计学意义（χ2＝5．231、5．661、6．294，均 P ＜0．05）。结论MRS 在前列腺癌的诊断中具有较高的应用价值，联合血清 PSA 或（和）DRE 能进一步提高诊断的准确率。%Objective To explore the diagnostic value of serum prostate specific antigen (PSA),digital rectal exami-nation (DRE),combined with magnetic resonance spectroscopy (MRS),on prostate cancer.Methods 107 cases pa-tients with prostatic hyperplasia or prostate placeholder checked by ultrasound examination,they were with serum PSA test and the PSA were abnormal,then they were checked by MRS and DRE,they were divided into PSA high-risk group (>20 ng/ml),PSA moderate group (10-20 ng/ml),PSA low-risk group (4-10 ng/ml)according to PSA leves,all pa-tients were with undergoing surgery or biopsy pathologic specimens and were with a final diagnosis of pathological diag-nosis results,analysed the diagnostic value of MRS,MRS with different serum PSA group,MRS+ DRE and MRS+DRE+PSA high-risk.Results The pathological diagnosis showed that there were 56 cases prostate cancer another 51 cases without prostate cancer,while MRS diagnosed that there were 57 cases prostate cancer another 50 cases without prostate cancer,MRS diagnosis and pathological diagnosis results were in good consistency (P <0.05);The diagnosis accuracy of MRS+PSA low-risk group,MRS+PSA moderate group and MRS+PSA high-risk group were 70.83%, 81.48%,93.75%,the MRS diagnosis was efficiency between different PSA group,the difference was statistically sig-nificant (χ2 =6.201,P <0.05);The diagnosis accuracy of MRS+DRE,MRS+PSA high-risk and MRS+DRE+PSA high-risk were 90.65%,93.75%,96.88%,they were significantly higher than that of pure MRS diagnosis,the differ-ence was statistically significant(χ2 =5.231、5.661、6.294,all P <0.05).Conclusion MRS has a high application value in the diagnosis of prostate cancer,joint serum PSA or (and)DRE can further improve the diagnostic accuracy.