摘要
目的:分析前列腺穿刺前多参数核磁共振(mp-MRI)影像学表现,探讨mp-MRI在前列腺癌诊断和治疗中的临床应用价值。方法:收集2019年1月—2019年12月于同济大学附属第十人民医院行前列腺穿刺活检术的110例疑似前列腺癌患者mp-MRI影像学资料和临床资料进行回顾性分析,参照穿刺病理和根治术后病理,评估mp-MRI在前列腺癌诊断和治疗中的应用价值。结果:110例患者中,病理结果提示前列腺癌50例,良性前列腺增生60例,前列腺mp-MRI对前列腺癌患者诊断的灵敏度、特异度、阳性预测值(PPV)、阴性预测值(NPV)分别为86%、80%、78%、87%;对于临床显著前列腺癌(csPCa)患者的灵敏度、特异度、PPV、NPV分别为88%、74%、69%、91%;ROC曲线分析mp-MRI诊断前列腺癌AUC值为0.830(95%CI为0.749~0.911);mp-MRI引导下的靶向联合系统穿刺组csPCa检出率(48%)高于系统穿刺组(26%),2组检出率比较差异有统计学意义(P<0.05)。mp-MRI对于TNM分期的预测准确率为64.55%(71/110),诊断前列腺癌包膜外侵犯、精囊侵犯的灵敏度、特异度分别为50%、71%和33%、91%。结论:mp-MRI对前列腺癌检出率高,可以引导靶向穿刺活检,用于评估前列腺癌临床分期,在PCa的诊断和治疗过程中具有重要的临床应用价值。
Objective:To analyze the application value of multi-parametric magnetic resonance imaging(mp-MRI)in the diagnosis of prostate cancer.Methods:110 patients were enrolled in this study,who were suspicious of prostate cancer and received prostate biopsy between January 2019 and December 2019.Pre-biopsy mp-MRI and clinical data were analyzed retrospectively.Results:50 cases of prostate cancer(PCa)and 60 cases of benign prostate hyperplasia(BPH)were confirmed by prostate biopsy.Sensitivity,specificity,PPV and NPV of mp-MRI were 0.86/0.80/0.78/0.87 for all prostate cancers and 0.88/0.74/0.69/0.91 for clinically significant prostate cancer(csPCa)respectively.The ROC-AUC was 0.830(95%CI:0.749~0.911).Detection rate of MRI-guided combined biopsy(SB+TB)was significantly higher than systematic biopsy(SB)(48%VS 26%,P<0.05).Predicting accuracy for TNM staging was 64.55%(71/110).Sensitivity and specificity of mp-MRI for predicting extraprostatic extension(pT3a),seminal vesicle invasion(pT3b)were 0.50/0.71and 0.33/0.91 respectively.Conclusion:Mp-MRI can detect prostate cancer,guide prostate biopsy and predict clinical stage,which play a significant role in evaluating and treating prostate cancer.
作者
艾麦提阿吉·喀迪尔
鄢阳
于洋
郭长城
王帅
赵炳辉
彭波
姚旭东
AIMAITIAJI Kadier;YAN Yang;YU Yang;GUO Changcheng;WANG Shuai;ZHAO Binghui;PENG Bo;YAO Xudong(Department of Urology,The Affiliated Tenth People's Hospital of Tongji University,Shanghai 200072,China)
出处
《淮海医药》
CAS
2021年第4期336-340,共5页
Journal of Huaihai Medicine
基金
上海市科委引导项目(19411967700)。
关键词
前列腺肿瘤
多参数核磁共振
诊断
Prostate cancer
Multi-parametric magnetic resonance imaging
Diagnosis
作者简介
艾麦提阿吉·喀迪尔(1989-),男,主治医师,在读博士;通信作者:姚旭东,E-mail:yaoxudong1967@163.com。
