Abstract:

Objective　To explore the value of multiparametric magnetic resonance imaging (mpMRI), transrectal ultrasound (TRUS), and serum prostate-specific antigen (PSA) in the diagnosis of prostate cancer. Methods　One hundred and thirty patients suspected with prostate cancer and treated at Xi'an Daxing Hospital between August 2020 and August 2023 were selected as the study objects. They were 28-63 (45.02±5.36) years old. The pathological results were set as the gold standard. All the patients underwent mpMRI, TRUS, and the detection of the serum level of PSA. The values of mpMRI, TRUS, and the serum level of PSA in the diagnosis of prostate cancer were assessed by the receiver operating characteristic curves (ROC). χ² and t tests were used for the statistical analysis. Results　The pathological results showed that 75 cases had prostate cancer, and 55 cases benign prostatic hyperplasia. The proportions of the patients with the PI-RADS score of 1-2 and 3 in the prostate cancer group were lower than those in the benign prostatic hyperplasia group [12.00% (9/75) vs. 63.64% (35/55) and 20.00% (15/75) vs. 30.91% (17/55)], and the proportions of the patients with the PI-RADS score of 4 and 5 were higher [50.67% (38/75) vs. 5.45% (3/55) and 7.33% (13/75) vs. 0], with a statistical difference (P<0.05). The serum level of PSA in the prostate cancer group was lower than that in the benign prostatic hyperplasia group [(40.36±5.67) μg/L vs. (16.75±2.17) μg/L], with a statistical difference (t=29.322; P<0.05). Sixty cases were diagnosed with malignancy by mpMRI, 53 by TRUS, 54 by serum PSA, and 68 by their combination. The ROC analysis results showed that the sensitivity and specificity of their combination for prostate cancer were 90.7% and 89.1%, respectively, with an area under the curve of 0.899. Conclusions　mpMRI and TRUS combined with the serum level of PSA demonstrates a high sensitivity and a high specificity in the diagnosis of prostate cancer. Their combination exceeds any one of them, and can increase the diagnostic accuracy for prostate cancer.

Key words:

Prostate cancer, Multiparametric magnetic resonance imaging, Transrectal ultrasound, Serum prostate-specific antigen, Diagnostic value

摘要：

目的　探讨多参数磁共振成像（mpMRI）、经直肠超声（TRUS）联合血清前列腺特异性抗原（PSA）诊断前列腺癌的价值。方法　选取2020年8月至2023年8月西安大兴医院收治的130例疑似前列腺癌患者为研究对象，年龄28～63（45.02±5.36）岁。所有患者均进行mpMRI、TRUS检查及血清PSA水平检测。以病理结果作为金标准，采用受试者操作特征曲线（ROC）评估mpMRI、TRUS联合血清PSA水平诊断前列腺癌的价值。采用χ²检验、t检验进行统计分析。结果　病理结果诊断出前列腺癌患者75例，前列腺良性增生患者55例。前列腺癌组PI-RADS评分中1～2、3分患者占比低于前列腺良性增生组［12.00%（9/75）比63.64%（35/55）、20.00%（15/75）比30.91%（17/55）］，4、5分患者占比高于前列腺良性增生组［50.67%（38/75）比5.45%（3/55）、7.33%（13/75）比0］，差异有统计学意义（P<0.05）。前列腺癌组血清PSA水平高于前列腺良性增生组［（40.36±5.67）μg/L比（16.75±2.17）μg/L］，差异有统计学意义（t=29.322，P<0.05）。经mpMRI诊断出恶性60例，经TRUS诊断出恶性53例，经血清PSA诊断出恶性54例，经联合诊断出恶性68例；ROC分析结果显示，mpMRI、TRUS联合血清PSA水平诊断前列腺癌的灵敏度、特异度分别为90.7%、89.1%，曲线下面积（AUC）为0.899。结论　mpMRI、TRUS联合血清PSA水平诊断前列腺癌的灵敏度和特异度较高，优于单一检测方法，能有效提高前列腺癌的诊断准确性。

关键词:

前列腺癌, 多参数磁共振成像, 经直肠超声, 血清前列腺特异性抗原, 诊断价值