多模态超声对侵袭性前列腺癌的诊断价值及ROC曲线分析研究

目的：探讨多模态超声(MUS)对侵袭性前列腺癌(PCa)的诊断价值及受试者工作特征(ROC)曲线分析。方法：选择2018年01月至2021年02月于本院行手术切除并经病理证实的86例PCa患者作为研究对象,根据病理Gleason评分可分为两组,高侵袭组(Gleason＞4+3,共46例),低-中侵袭组(Gleason≤4+3,共40例)。所有患者术前均行MUS检查,包括经直肠常规超声(TRUS)、剪切波弹性成像(SWE)、超声造影(CEUS)。比较两组之间各参数的差异,采用ROC曲线分析其对高侵袭组PCa的诊断效能。结果：高侵袭组与低-中侵袭组的TRUS表现显著不同(P<0.05),其中高侵袭组中TRUS主要表现为弥漫性。高侵袭组SWE中SR比值(23.86±13.67)显著高于低-中侵袭组(12.82±11.95),差异具有统计学意义(P<0.05)。高侵袭组的CEUS参数中初始强度、峰值强度显著高于低-中侵袭组(P<0.05),而两组达峰时间、峰值减半时间无显著差异(P>0.05)。MUS对高侵袭组PCa诊断的ROC曲线下面积最大,敏感度、特异度也最高(P<0.05)。结论：MUS对高侵袭性PCa具有更高的诊断价值,有助于指导临床对治疗方案的选择。

The Diagnostic Value of Multimodal Ultrasonography for Invasive Prostate Cancer and ROC Curve Analysis

Objective:To investigate the diagnostic value of multimodal ultrasound (MUS) in invasive prostate cancer (PCA) and the analysis of receiver operating characteristic (ROC) curve.Methods:A total of 86 PCA patients who underwent surgical resection and were pathologically confirmed in our hospital from January 2018 to February 2021 were selected as the research subjects. According to pathological Gleason score, they could be divided into two groups: the highly invasive group (Gleason gt;All patients in the low-to-medium invasion group (Gleason 4+3, 40 cases) underwent MUS examination before surgery, including conventional transrectal ultrasound (TRUS) shear wave elastography (SWE) contrast-enhanced ultrasound (CEUS).The difference of parameters between the two groups was compared, and the diagnostic efficacy of PCA in the highly invasive group was analyzed by ROC curve.Results: The TRUS performance of the high invasion group was significantly different from that of the low-medium invasion group (P<0.05), and the TRUS in the high invasion group was mainly diffuse. The SR ratio of SWE in the high invasion group (23.86±13.67) was significantly higher than that in the low-medium invasion group (12.82±11.95), and the difference was statistically significant (P<0.05). The initial intensity and peak intensity of the CEUS parameters of the high invasion group were significantly higher than those of the low-medium invasion group (P<0.05), but there was no significant difference in peak time and peak halving time between the two groups (P>0.05). MUS had the largest area under the ROC curve in the diagnosis of PCa in the high-invasive group, as well as the highest sensitivity and specificity (P<0.05).Conclusion: MUS has a higher diagnostic value for highly aggressive PCa and helps guide the clinical choice of treatment options.