本文選題：前列腺增生 + 前列腺腫瘤�。� 參考：《重慶醫(yī)學(xué)》2017年22期

【摘要】：目的評(píng)估前列腺影像報(bào)告與數(shù)據(jù)系統(tǒng)(PIRADS v2)對(duì)前列腺特異性抗原(PSA)灰區(qū)前列腺癌(PCa)的診斷價(jià)值。方法納入2012-2016年總共2 200例行前列腺磁共振成像(MRI)檢查病例中PSA為4~10ng/mL,穿刺活檢或手術(shù)切除前行多參數(shù)MRI(mp-MRI)檢查,未接受任何形式治療的PCa及前列腺增生(BPH)患者,收集mp-MRI圖像及臨床資料,回顧性分析其mp-MRI,根據(jù)PIRADS v2對(duì)所有病灶定量評(píng)分,記錄PIRADS v2分值及病灶所在區(qū)域。以經(jīng)直腸超聲(TRUS)引導(dǎo)穿刺活檢或手術(shù)切除標(biāo)本病理結(jié)果為金標(biāo)準(zhǔn)。運(yùn)用ROC曲線計(jì)算PIRADS v2診斷PSA灰區(qū)PCa的診斷價(jià)值,Logistic回歸分析前列腺癌的危險(xiǎn)因素。結(jié)果共納入15例PCa患者和30例BPH患者,兩組患者在年齡、tPSA、fPSA、f/tPSA、前列腺體積、PSA密度(PSAD)差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。PIRADS v2診斷PCa的曲線下面積(AUC)=0.932(95%CI 0.822~0.984),P0.01;最佳切點(diǎn)為PIRADS v2≥4分,診斷敏感性為88.89%,特異性為87.10%,陽(yáng)性預(yù)測(cè)值為80.00%,陰性預(yù)測(cè)值為93.10%。Logistic回歸顯示,PIRADS v2評(píng)分是PCa的獨(dú)立預(yù)測(cè)因子,Hazard Ratio(HR)=17.847(3.745~85.078),P0.01。PIRADS v2評(píng)分與病理Gleason評(píng)分呈正相關(guān)(r=0.585,P=0.022)。結(jié)論 PIRADS v2評(píng)分對(duì)PSA灰區(qū)PCa具有較高的診斷價(jià)值,且與病理結(jié)果具有相關(guān)性。
[Abstract]:Objective to evaluate the diagnostic value of prostate imaging report and data system (PIRADS v2) for prostate cancer (PCA) in the gray area of prostate specific antigen (PSA).Methods A total of 2 200 patients with prostatic magnetic resonance imaging (PSA) from 2012 to 2016 were enrolled in this study. PSA was 4ng / mL. MRImp-MRI was performed with multiple parameters before puncture biopsy or surgical resection. Patients with PCa and benign prostatic hyperplasia (BPH) who did not receive any form of treatment were enrolled in this study.Mp-MRI images and clinical data were collected and mp-MRI was analyzed retrospectively. According to the quantitative score of PIRADS v2, the score of PIRADS v2 and the location of the lesion were recorded.The results of transrectal ultrasound trust guided biopsy or surgical resection were regarded as gold standard.ROC curve was used to calculate the diagnostic value of PIRADS v2 in the diagnosis of PCa in PSA grey area. Logistic regression analysis was used to analyze the risk factors of prostate cancer.Results there were 15 patients with PCa and 30 patients with BPH. There was no significant difference in the area under the curve between the two groups in the diagnosis of PCa. The best cut point was PIRADS v2 鈮，

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