PSA及其相关指标对前列腺癌的诊断价值

李明; 周剑芳; 高诚; 阳东荣

doi:10.13201/j.issn.1001-1420.2019.12.018

PSA及其相关指标对前列腺癌的诊断价值

- 苏州大学附属第二医院泌尿外科(江苏苏州, 215004)

详细信息

通讯作者: 阳东荣,E-mail:doc_ydr@163.com

中图分类号: R737.25

收稿日期: 2018-10-29

Predictive value of PSA and its related indicators in the diagnosis of prostate cancer

- Department of Urology, Affiliated Second Hospital, Soochow University, Suzhou, Jiangsu, 215004, China

More Information

Corresponding author: YANG Dongrong, E-mail: doc_ydr@163.com

Received Date: 29 October 2018

摘要

摘要: 目的：探讨当患者前列腺MRI影像报告和数据系统（PI-RADS V2）评分为3分，且前列腺特异性抗原（PSA）位于灰区（4.0~10.0 ng/ml）时，PSA及其相关指标对前列腺癌（PCa）的诊断价值。方法：回顾性分析2015年1月~2018年5月于苏州大学附属第二医院行MRI检查PI-RADS V2评分为3分、PSA值位于灰区且经穿刺病理证实为前列腺疾病患者的临床资料。受试者工作特征（ROC）曲线分析各指标对PCa的诊断价值，并利用Logistic回归分析筛选出危险预测因子，建立危险评估模型。结果：总计55例患者，其中PCa 24例（PCa组），非PCa 31例（非PCa组）。两组前列腺特异性抗原密度（PSAD）和游离PSA/总PSA（F/T）比较差异有统计学意义（P<0.05）。PSAD诊断PCa的cut-off值为0.145 ng/ml²，灵敏度和特异度分别为83.3%和90.3%（P<0.05）；F/T诊断PCa的cut-off值为0.174，灵敏度和特异度分别为75.0%和87.1%（P<0.05）；PSAD+F/T联合诊断PCa的cut-off值为0.295，灵敏度和特异度分别为91.3%和78.2%（P<0.05）。利用危险预测因子PSAD和F/T建立患癌风险评估模型：logit（p）=（-3.745 798）+（-12.139 21）×F/T+38.928 53×PSAD。结论：对于PI-RADS V2评分为3分且PSA位于灰区的患者，PSAD、F/T单独应用及联合诊断均能有效提高对PCa诊断的灵敏度，避免漏诊。危险评估模型凭借灵敏度高、使用便捷等优点，在PCa诊断中值得进一步推广。
- 前列腺癌 /
- 前列腺MRI影像报告和数据系统 /
- 前列腺特异性抗原密度 /
- 游离PSA/总PSA /
- 前列腺特异性抗原灰区风险预测模型
Abstract: Objective: To explore the diagnostic value of PSA and its related indicators for prostate cancer when the prostate MRI imaging report and data system(PI-RADS V2) score was 3 and PSA was located in gray area(4.0-10.0 ng/ml). Method: The clinical data of patients who underwent MRI examination from January 2015 to May 2018 in Second Affiliated Hospital of Soochow University with PI-RADS V2 score of 3 and PSA value in the gray area were retrospectively analyzed. ROC analyzed the diagnostic value of each indicator and establish a prediction model through analysis of Logistic regression. Result: A total of 55 patients were treated, There were 24 cases of PCa and 31 cases of others. PSAD cut-off value was 0.145 ng/ml², sensitivity and specificity were 83.3% and 90.3%(P<0.05) respectively. fPSA/tPSA(F/T) cut-off value was 0.174, sensitivity and specificity were 75.0% and 87.1%(P<0.05) respectively. PSAD+F/T combined with cut-off value was 0.295, sensitivity and specificity were 91.3% and 78.2% respectively. PSAD and F/T risk predictors were used to establish a cancer risk assessment model:logit(p)=(-3.745 798)+(-12.139 21) ×F/T+38.928 53×PSAD.Conclusion: For patients with PSA in grey area, independent application of PSAD or F/T or combination of them can improve sensitivity of PCa and reduce meaningless biopsy. Risk assessment model is worth promotion because of its high diagnostic sensitivity and easy application.
- prostate cancer /
- PI-RADS V2 /
- PSAD /
- fPSA/tPSA /
- risk assessment model of grey area of PSA

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