PI-RADS v2为3分时运用PSAMR诊断前列腺癌的价值

目的 探讨根据第2版前列腺影像报告与数据系统v2（PI-RADS v2）为3分时运用前列腺特异抗原质量比（PSAMR）诊断前列腺癌的效能。方法 回顾性分析攀枝花学院附属医院2016年1月至2020年8月收治的81例PI-RADS v2为3分患者的临床资料,所有患者行多参数磁共振成像（MRI）检查,均在B超引导下穿刺活检。以病理诊断结果为诊断标准,将患者分为前列腺癌组（19例）和非前列腺癌组（62例）。比较两组年龄、前列腺体积、前列腺特异抗原（PSA）、PSA密度（PSAD）、PSA质量（PSAM）及PSA质量比（PSAMR）之间的差异,运用受试者工作特征（ROC）曲线评价各指标在PI-RADS v2为3分前列腺癌中的诊断效能。结果 单因素分析结果显示,前列腺癌组的年龄、PSA、PSAD、PSAM、PSAMR、前列腺体积与非前列腺癌组比较,差异均有统计学意义（均P<0.05,表2）。多因素logistic回归分析结果显示,PSAD、PSAM及PSAMR与前列腺癌诊断有相关性（均P<0.05）。SMAR诊断PI-RADS v2为3分前列腺癌的ROC曲线下面积及特异度均高于其他三项指标。结论 PSAMR在诊断PI-RADS v2为3分的前列腺癌患者中具有较高的效能,临床工作中判断为PI-RADS v2为3分的前列腺疾病患者可以借助PSAMR得出更为准确的诊断。

Application value of PSAMR in the diagnosis of prostate cancer when PI-RADS v2 is 3 points

Objective To investigate the efficacy of prostate imaging reporting and data system v2(PI-RADS v2)at 3 points in the diagnosis of prostate cancer by using prostate specific antigen mass ratio (PSAMR).Methods The clinical data of 81 patients with PI-RADS v2 score of 3 who were admitted to the affiliated hospital of Panzhihua university from January 2016 to August 2020 were retrospectively analyzed. All patients underwent multi parameter MRI examination and needle biopsy guided by B-ultrasound. Based on pathological diagnosis, patients were divided into prostate cancer group (19 cases) and non prostate cancer group (62 cases). The differences of age, prostate volume, PSA, PSAD, PSAM and PSAMR between two groups were compared. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of each index in prostate cancer with PI-RADS v2 score of 3.Results Single factor analysis of the basic data of the two groups showed that there were statistically significant differences in age, PSA, PSAD, PSAM, PSAMR and prostate volume between the two groups (all P<0.05). Multivariate logistic regression analysis showed that there were statistically significant differences in PSAD, PSAM and PSAMR between the two groups (all P<0.05). The areas under ROC curve of PSA, PSAD, PSAM and PSAMR in diagnosing PI-RADS v2 with 3 points of prostate cancer were 0.703, 0.769, 0.790 and 0.823, respectively. The specificity of PSA, PSAD, PSAM and PSAMR in the diagnosis of PI-RADS v2 was 0.889, 0.722, 0.889 and 0.944, respectively. The sensitivity of PSA, PSAD, PSAM and PSAMR in diagnosing PI RADS v2 was 0.468, 0.742, 0.694 and 0.645, respectively. The area and specificity under ROC curve of PSMAR diagnosis were higher than the other three indexes.Conclusions PSAMR has high diagnostic efficiency in the diagnosis of prostate cancer patients with PI-RADS v2 score of 3, and the patients with prostate disease whose PI-RADS v2 score is 3 in clinical work can get more accurate diagnosis with PSAMR.