磁共振PIRADS v2对PSA 4～20 ng/mL区段前列腺癌的诊断价值

张天戈; 余舟; 刘迎; 郭吉楠; 谢京; 刘增钦; 黄向江

doi:10.13201/j.issn.1001-1420.2020.12.010

磁共振PIRADS v2对PSA 4～20 ng/mL区段前列腺癌的诊断价值

- 深圳市人民医院泌尿外科(广东深圳, 518020)

详细信息

通讯作者: 余舟,E-mail:287858096@qq.com

中图分类号: R737.25

收稿日期: 2020-08-11

Diagnostic value of PIRADS v2 in prostate cancer with PSA level of 4-20ng/mL

- Department of Urology, Shenzhen People's Hospital, Shenzhen, Guangdong, 518020, China

More Information

Corresponding author: YU Zhou, E-mail: 287858096@qq.com

Received Date: 11 August 2020

摘要

摘要: 目的:探究前列腺影像报告和数据系统(PIRADS v2)在前列腺特异性抗原(PSA)4~20 ng/mL区段中诊断前列腺癌(PCa)的价值。方法:选择2018~2019年我院前列腺穿刺活检患者中PSA 4~20 ng/mL且行mp-MRI及PIRADS评分的患者255例,分为70前列腺癌(PCa)患者和185例良性前列腺增生(BPH)患者两组,收集其多参数MR(mp-MRI)图像和临床资料,回顾性分析mp-MRI,记录PIRADS v2下所有病灶的分值及病灶所在区域。以MRI经直肠超声融合(MRI-TRUS)引导下前列腺穿刺活检标本病理结果为金标准。运用Roc曲线计算PIRADS v2在PSA 4~20 ng/mL区段中的诊断价值,Logistic回归分析PCa的危险因素。结果:两组患者PIRADS v2诊断PCa的曲线下面积为0.698(95%CI 0.623~0.772),P＜0.01,PIRADS v2评分4分为最佳切点,其诊断特异性为71.9%,敏感性为63.4%。Logistic回归显示,PIRADS v2评分是PCa的独立预测因子(P＜0.01)。PIRADS v2评分与病理Gleason评分呈正相关(rs=0.425,P=0.002 46＜0.05)。结论:PIRADS v2评分在PSA 4~20 ng/mL区段中对PCa的诊断具有较高价值,其在PSA＞10~20 ng/mL区段的诊断价值要高于灰区4~10 ng/mL的诊断价值,且与病理结果具有相关性。
- 前列腺癌 /
- 前列腺穿刺 /
- 多参数磁共振 /
- 前列腺影像报告与数据系统v2
Abstract: Objective: To explore the value of prostate imaging reporting and data system(PIRADS v2) in the diagnosis of prostate cancer(PCa) in prostate specific antigen(PSA) level of 4-20 ng/mL. Method: From 2018 to 2019, 255 prostatic hyperplasia(BPH) and PCa patients in our hospital with PSA level of 4-20 ng/mL were subsumed. They all received multiparametric magnetic resonance imaging(MP-MRI) with PIRADS v2 before biopsy and their MP-MRI and clinical data were collected. We retrospectively analyzed the results of mp-MRI and recorded the scores of all lesions according to PIRADS v2 and the location of the lesions. The pathological results of MRI transrectal ultrasound(MRI-TRUS) fusion guided prostate biopsy specimens were the gold reference. The diagnostic value of PIRADS v2 in PSA levels of 4-20 ng/mL was calculated by receiver operating characteristic(ROC) curve, and the risk factors of PCa were analyzed by logistic regression analysis. Result: Seventy PCa and 185 BPH patients were included. The area under ROC curve of PIRADS v2 in diagnosing PCa was 0.698(95%CI 0.623-0.772)(P＜0.01) with a best cutoff PIRADS score of 4, and the diagnosis specificity was 71.9% and sensitivity 63.4%. Logistic regression shows that PIRADS v2 is an independent predictor of PCa(P＜0.01). PIRADS v2 score was positively correlated to gleason score(rs=0.425, P=0.002 46＜0.05).Conclusion: PIRADS v2 score has high value in the diagnosis of PCa in PSA level of 4-20 ng/mL, and the diagnostic value in the PSA level of(10, 20) ng/mL was significantly higher than that in the gray zone 4-10 ng/mL. PIRADS v2 score is related to pathological results.
- prostate cancer /
- prostate biopsy /
- multiparametric magnetic resonance imaging /
- prostate imaging reporting and data system version 2

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