| 陈志远,张艳,周懂晶,黄丽霞,刘玉品,胡萍,郑广娟.前列腺特异性抗原密度在前列腺影像报告和数据系统第二版评分为3分患者临床决策中的应用[J].中国医学影像技术,2018,34(6):906~910 |
| 前列腺特异性抗原密度在前列腺影像报告和数据系统第二版评分为3分患者临床决策中的应用 |
| Value of prostate specific antigen density in clinical decision-making for prostate imaging reporting and data system v2 category 3 lesions |
| 投稿时间：2017-12-01 修订日期：2018-04-03 |
| DOI：10.13929/j.1003-3289.201712009 |
| 中文关键词: 前列腺影像报告和数据系统 前列腺肿瘤 前列腺特异抗原 活组织检查 磁共振成像 |
| 英文关键词:Prostate imaging reporting and data system Prostate neoplasm Prostate-specific antigen Biopsy Magnetic resonance imaging |
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| 中文摘要: |
| 目的 探讨动态对比增强MRI （DCE-MRI）鉴别低级别与高级别前列腺癌的价值。方法 回顾性分析经前列腺癌根治术后病理证实并于术前接受前列腺DCE-MRI的26例前列腺癌患者的资料，根据病理结果分为低级别组（n=10）和高级别组（n=16），测量并比较2组间前列腺癌转运常数（Ktrans）、速率常数（Kep）及血管外细胞外间隙体积百分数（Ve）的差异，绘制ROC曲线，评价各参数值鉴别低级别与高级别前列腺癌的诊断效能，并分析各参数与Gleason评分的相关性。结果 低级别前列腺癌组Ktrans、Kep及Ve值分别为（0.22±0.07）/min、（1.24±0.57）/min和0.21±0.08，高级别组分别为（0.36±0.10）/min、（1.82±0.66）/min和0.21±0.10，2组间Ktrans及Kep值差异均有统计学意义（P均<0.05），Ve值差异无统计学意义（P=0.994）。Ktrans、Kep值区分前列腺高级别癌和低级别癌的ROC曲线下面积分别为0.872和0.737。前列腺癌Ktrans、Kep、Ve值与Gleason评分均无相关（P均>0.05）。结论 DCE-MRI定量参数Ktrans和Kep有助于鉴别低级别与高级别前列腺癌。 |
| 英文摘要: |
| Objective To explore the value of prostate specific antigen density (PSAD) in clinical decision-making for patients with prostate imaging reporting and data system version 2 (PI-RADS v2) category 3 lesions. Methods Totally 54 patients with PI-RADS v2 category 3 lesions who underwent prostate biopsy before MRI were enrolled and divided into prostate cancer (PCa) group (n=11) and benign group (n=43) according to biopsy results. Then clinical data and imaging features, including total prostate specific antigen (TPSA), free prostate specific antigen (FPSA), FPSA/TPSA ratio (F/T), PSAD, prostate volume and the volume of index lesion were collected and statistically analyzed between the two groups. ROC curve was used to evaluate the diagnostic efficacy of PSAD in predicting malignant and benign lesions in patients with PI-RADS v2 category 3 lesions. Results PSAD had statistical difference (P=0.006), whereas TPSA, FPSA, F/T, prostate volume and the volume of index lesion showed no statistical differences between PCa group and benign group (all P>0.05). ROC curves showed that area under the curve was 0.771(P<0.05). Using the optimal threshold of PSAD=0.25 ng/ml2, the sensitivity and specificity of PSAD in predicting PCa and benign lesions was 72.73% (8/11) and 74.42%(32/43), respectively. Conclusion PSAD is an effective index to predict the risk of PCa in patients with PI-RADS v2 category 3 lesions. Using the threshold of PSAD=0.25 ng/ml2 to screen high risk patients for prostate biopsy, the positive rate could be improved and unnecessary biopsies could be avoided. |
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