PSAD联合DCE-MRI对前列腺癌诊断价值的研究

摘要

目的 探讨前列腺特异性抗原(PSA)、前列腺特异性抗原密度(PSAD)联合动态增强扫描磁共振成像(DCE-MRI)定量参数Ktrans、Kep、Ve对前列腺癌(PCa)的诊断价值.方法 选取马鞍山市人民医院2015年5月至2016年6月前列腺患者66例,其中PCa 25例、前列腺增生(BPH)41例.所有患者均行DCE-MRI检查、PSA检测,将得出结果按照11种组合方案,参照病理结果,绘制受试者特性曲线(ROC),比较所有诊断方案的灵敏度、特异度及准确度.结果 BPH组患者的PSA、PSAD、Ktrans、Kep、Ve分别为(14.72±12.86)ng/mL、(0.25±0.23)ng/(mL·cm3)、(0.22±0.10)/min、(1.35±0.59)/min、(0.17±0.07),PCa组患者分别为(30.42±23.90)ng/mL、(0.84±0.52)ng/(mL·cm3)、(0.52±0.18)/min、(2.51±1.10)/min、(0.24±0.10),BPH组患者的参数均低于PCa组,差异均有显著统计学意义(P<0.01).单参数诊断方案中Ktrans诊断价值最高,灵敏度、特异度、AUCROC分别为85.7%、90.2%、0.93.PSAD+Ktrans在11种组合方案中诊断价值最高,灵敏度、特异度、AUCROC分别为90.5%、95.1%、0.96.结论 PSAD及DCE-MRI定量参数Ktrans、Kep对前列腺癌有较好的诊断价值,PSAD联合Ktrans为前列腺良恶性病变的鉴别诊断提供了重要的参考.%Objective To investigate the diagnostic value of prostate specific antigen (PSA), prostate specific antigen dencity (PSAD) combined with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantita-tive parameters, Ktrans, Kep, Ve on prostate cancer (PCa). Methods Sixty-six patients with PCa were collected from May 2015 to June 2016 in the People's Hospital of Ma'anshan, including 25 cases of PCa and 41 cases of benign prostatic hy-perplasia (BPH). All patients underwent DCE-MRI and PSA test. The results showed that the receiver operating charac-teristic curve (ROC) was drawn according to the results of 11 combinations and the pathological results, and the sensi-tivity, specificity and accuracy of all the diagnostic protocols were compared. Results The PSA, PSAD, Ktrans, Kep and Ve values of the BPH group were (14.72 ± 12.86) ng/mL, (0.25 ± 0.23) ng/(mL·cm3), (0.22 ± 0.10)/min, (1.35 ± 0.59)/min, (0.17 ± 0.07), which were significantly lower than (30.42 ± 23.90) ng/mL, (0.84 ± 0.52) ng/(mL·cm3), (0.52 ± 0.18)/min, (2.51 ± 1.10)/min, (0.24 ± 0.10) of PCa group, P<0.01. The value of Ktrans diagnosis in single parameter diagnosis was the highest, and the sensitivity, specificity and AUCROC were 85.7%, 90.2%, and 0.93, respectively. PSAD+Ktrans had the highest diagnostic value in 11 combinations, and the sensitivity, specificity and AUCROC were 90.5%, 95.1%, and 0.96, respectively. Conclusion PSAD and DCE-MRI quantitative parameters Ktrans, Kep have a good diagnostic value in pros-tate cancer. PSAD combined with Ktrans provides an important reference for the differential diagnosis of benign and malig-nant lesions of the prostate.