基于多参数磁共振成像的PI-RADS第二版评分联合f/tPSA及PSAD在前列腺癌早期筛查中的预测价值

目的 探讨基于多参数磁共振成像的PI-RADS第二版评分联合f/t PSA及PSAD在前列腺癌早期筛查中的预测价值。方法 回顾性分析2015年1月至2020年12月期间的289例疑似前列腺癌患者的临床资料,根据是否确诊前列腺癌分为前列腺癌组和非前列腺癌组,绘制患者PI-RADS第二版评分、f/tPSA及PSAD三项诊断指标的受试者工作特征曲线,并计算曲线下面积（AUC）,分析三个诊断指标以及联合指标对PCa的灵敏度和特异度。结果 一致性检验显示Kappa系数为0.798,说明两名医师的评分结果具有高度一致性。289例前列腺癌患者中,PCa组及非PCa组患者在PI-RADS第二版评分、f/t PSA及PSAD三项诊断指标的差异均有统计学意义。f/t PSA、PI-RADS第二版评分、PSAD三项诊断指标以及联合指标的AUC分别为0.633、0.796、0.785和0.908（P<0.001）。结论 基于多参数磁共振成像的PI-RADS第二版评分联合f/t PSA及PSAD可作为前列腺癌早期筛查的客观指标。

The predictive value of PI-RADS v2 based on multi-parameter magnetic resonance imaging combined with f/t PSA and PSAD in prostate cancer

Objective To investigate the predictive value of PI-RADS V2 based on multi-parameter magnetic resonance imaging combined with f/t PSA and PSAD in prostate cancer. Methods All the clinical data of 289 patients with suspected prostate cancer were analyzed in the hospital of Yangchun city from January 2015 to December 2020, retrospectively. 123 patients with prostate cancer （PCa） were selected as PCa group, and 166 cases without PCa were selected as Non-PCa group. The receiver operator characteristic curve were performed to verify the diagnostic value of PI-RADS v2, the f/t PSA and PSAD, and the area under curve （AUC） were calculated. The sensitivity and specificity of the prostate cancer were analyzed by three diagnostic indicators and joint indicators. Results The consistency test between two groups showed that Kappa coefficient was 0.798, which indicated that the scoring results of the two physicians were highly consistent. The AUC of the diagnostic indexes of PI-RADS v2, f/t PSA, PSAD and the combined indexes were 0.633, 0.796, 0.785 and 0.908, respectively.The difference was statistically significant. Conclusion PI-RADS v2 combined with f/t PSA and PSAD can be used as Objective indicators for the early diagnosis of prostate cancer, and it is worthy of promotion.