血清PSA水平下降速率联合改良PI-RADS评分在鉴别前列腺良性疾病与前列腺癌中的价值

目的探讨血清前列腺特异性抗原(PSA)水平下降速率联合改良前列腺影像报告和数据系统(PI-RADS)评分在鉴别前列腺良性疾病和前列腺癌中的价值。方法回顾分析80例行前列腺穿刺活检患者的临床资料,根据病理结果分为前列腺良性疾病组和前列腺癌组,绘制受试者工作特征曲线(ROC)确定阈值,比较两组PSA水平下降速率、PI-RADS评分、血常规和尿液白细胞等相关参数,采用t检验或Z检验等统计方法探讨这些参数在鉴别前列腺良性疾病和前列腺癌中的价值。结果两组相比,PSA水平下降速率、改良PI-RADS评分、淋巴细胞百分比和尿液白细胞差异有统计学意义(P<0.01)。两组血常规中白细胞计数、中性粒细胞计数、中性粒细胞百分比、单核细胞百分比差异无统计学意义(P>0.01)。通过ROC确定,PSA下降速率阈值为3.175 ng/mL时,对前列腺疾病鉴别诊断符合率最高。再结合改良PI-RADS评分,使得前列腺疾病诊断符合率大幅提升。结论使用血清PSA水平下降速率联合改良PI-RADS评分鉴别前列腺良性疾病和前列腺癌,可提高前列腺穿刺阳性率。

The diagnostic value of PSA decline rate combined with modified PI-RADS score in the identification of benign prostatic diseases and prostate cancer

Objective To investigate the diagnostic value of PSA decline rate combined with modified PI-RADS score in the identification of benign prostatic diseases and prostate cancer.Methods The clinical data of 80 patients undergoing prostate biopsy were reviewed.According to the pathological results,the patients were divided into benign prostate disease group and prostate cancer group.The receiver operating characteristic(ROC)curve was drawn to determine the threshold,the parameters in the identification of benign prostatic diseases and prostate cancer were compared,and the diagnostic value of the parameters was analyzed with t test or z test.Results There were significant differences in PSA decline rate and modified PI-RADS score between the two groups(P<0.01).There were no significant differences in leukocyte count and neutrophil count,neutrophil percentage and monocyte percentage between the two groups(P>0.01).When the threshold of PSA decline rate determined by ROC was 3.175 ng/mL,the differential diagnosis rate of prostate diseases was the highest.If the PSA decline rate was combined with modified PI-RADS score,the diagnostic rate of prostate diseases could increase significantly.Conclusion The PSA decline rate combined with modified PI-RADS score can be used to differentiate benign prostate diseases and prostate cancer,and improve the positive rate of prostate puncture.