PI-RADS V2.1在各PSA区间对前列腺癌的诊断价值研究

目的探讨PI-RADS V2.1在不同PSA区间对前列腺癌(PCa)的诊断价值。方法选取442例行前列腺mpMRI检查并获得病理结果的患者纳入分析。按PSA水平4~10 ng/ml、10~20 ng/ml及>20 ng/ml分为3组,由两名医师分别对3组患者的MRI图像进行V2.1评分,运用Kappa检验评估两名医师评价结果的一致性。通过绘制ROC曲线评估V2.1对PCa的诊断效能并计算曲线下面积AUC。结果3组间的年龄和PCa患病率差异具有统计学意义(P<0.001)。Kappa值随PSA值的上升而升高(0.547、0.709、0.763)。AUC值随PSA值的上升而升高(0.835、0.873、0.921)。结论PI-RADS V2.1对各PSA区间PCa的诊断均具有较高的价值,随着PSA的升高其诊断效能也在提升。

Study on PI-RADS version 2.1 in predicting prostate cancer at different PSA levels

Objective To investigate the diagnostic value of PI-RADS Version 2.1(V2.1)for prostate cancer(PCa)at different serum prostate-specific antigen(PSA)levels.Methods 442 patients who underwent prostate mpMRI and obtained pathological results were included in the study.The study population were divided into 3 groups according to the serum PSA level(4~10 ng/ml,10~20 ng/ml,>20 ng/ml).Two readers performed V2.1 score on MRI images of patients in each group.The consistency of the results was evaluated by using Kappa statistic.The Receiver Operating Characteristic curve was drawn to evaluate the diagnostic efficacy of V2.1 for PCa.The areas under the curve(AUC)were calculated.Results There were significant differences in age and PCa prevalence among the three groups(P<0.001).Kappa values improved with increasing PSA levels(0.547,0.709,0.763,respectively).The AUC value improved with increasing PSA levels(0.835,0.873,and 0.921,respectively).Conclusion PI-RADS V2.1 shows excellent performance in predicting PCa in every PSA zone.With the increase of PSA,its diagnostic efficacy also improves.