| 汪蕾,肖峻,陶陶,王常明,沈德赟,胡传来.双参数磁共振成像-经直肠超声引导靶向穿刺与前列腺特异性抗原或前列腺特异性抗原密度组合对前列腺癌诊断价值的研究[J].中国临床保健杂志,2022,25(3):402-406. |
| 双参数磁共振成像-经直肠超声引导靶向穿刺与前列腺特异性抗原或前列腺特异性抗原密度组合对前列腺癌诊断价值的研究 |
| The value of bpMRI-TRUS targeted biopsy combined with PSA or PSAD in the diagnosis of prostate cancer |
| 投稿时间：2022-03-08 |
| DOI：10.3969/J.issn.1672-6790.2022.03.027 |
| 中文关键词: 前列腺肿瘤 多参数磁共振成像 穿刺术 前列腺特异抗原 |
| 英文关键词: Prostatic neoplasms Multiparametric magnetic resonance imaging Punctures Prostate-specific antigen 〖FL |
| 基金项目:安徽省重点研究与开发计划项目(202004J07020022,1804h08020253) |
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| 中文摘要: |
| 目的 探讨第2版前列腺影像报告和数据系统(PI-RADS)评分对前列腺癌的诊断意义,评估双参数磁共振成像(bpMRI)-经直肠超声(TRUS)引导靶向穿刺在不同前列腺特异性抗原(PSA)、前列腺特异性抗原密度(PSAD)分组中的诊断价值。方法 回顾性分析2017年1月至2021年1月于中国科学技术大学附属第一医院(安徽省立医院)行经会阴前列腺穿刺活检的374例患者的临床资料。将患者分为系统穿刺组(12针)和靶向穿刺组(12+X针)；分析2组患者的数据差异,再通过ROC曲线比较各临床参数对前列腺癌的诊断价值,比较系统穿刺和靶向穿刺在不同PSA和PSAD分组中对前列腺癌的诊断价值。结果 系统穿刺组和靶向穿刺组患者的年龄、体重指数、PSA、PSAD和前列腺癌患者的Gleason评分差异无统计学意义(P>0.05),但靶向穿刺组患者的PI-RADS评分和穿刺阳性率高于系统穿刺组(P<0.05)；ROC曲线表明,bpMRI对前列腺癌的诊断效能最高。PI-RADS评分在所有患者中、系统穿刺组和靶向穿刺组的AUC值分别为0.927、0.940和0.890,灵敏度分别为93.51%、89.47%和83.53%,特异度分别为80.91%、88.89%和80.41%；按不同PSA、PSAD值将患者进行分组,结果表明靶向穿刺(12+X)在4 μg/L0.15的患者中诊断能力要明显优于系统穿刺(P<0.05)。结论 基于bpMRI的PI-RADS评分系统对前列腺癌的诊断效能高,结合bpMRI影像报告和术中超声,对有可疑目标病灶的患者靶向穿刺(12+X)能明显提高诊断率。 |
| 英文摘要: |
| Objective To explore the diagnostic significance of PI-RADS score (version 2) for prostate cancer and evaluate the diagnostic value of bpMRI-TRUS targeted biopsy for prostate cancer in different PAS and PASD groups.Methods The clinical data of 374 patients underwent transperineal prostate biopsy in The First Affiliated Hospital of USTC (Anhui Provincial Hospital) during January 2017 and January 2021 was retrospectively analyzed.The patients were divided into systematic biopsy group with 12 cores and targeted biopsy group with 12+X cores;then analyzing the clinical characteristics of the two groups and comparing the diagnostic value of those clinical parameters for prostate cancer by ROC curves.Finally,comparing the diagnostic efficiency for prostate cancer of systematic biopsy group and targeted biopsy group in different PSA and PSAD groups.Results There were no significant differences in age,BMI,PSA,PSAD and Gleason score between the systematic biopsy group and the targeted biopsy group (P>0.05),but the PI-RADS score and positive rate of biopsy in the targeted biopsy group were higher than those in the systematic biopsy group (P<0.05).ROC curves showed that PI-RADS score had the highest diagnostic efficiency for prostate cancer.The AUC value of PI-RADS score were 0.927,0.940 and 0.890,the sensitivity of PI-RADS score were 93.51%,89.47% and 83.53% and the specificity of PI-RADS score were 80.91%,88.89% and 80.41% among all patients,the systematic biopsy group and the targeted biopsy group respectively.Then,patients were divided in groups according to different PSA and PSAD levels.The results showed that the diagnostic value of bpMRI-TRUS targeted biopsy (12+X) was significantly better than systematic biopsy (12) in patients with 4 μg/L0.15 (P<0.05).Conclusions PI-RADS scoring system has a great diagnostic capability for prostate cancer,bpMRI-TRUS targeted biopsy can obviously improve the diagnostic rate of prostate cancer in patients with suspicious regions. |
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