DCE-MRI参数联合血清PSA水平对前列腺癌分化程度的鉴别价值

Differential value of DCE-MRI parameters combined with serum PSA levels in differentiation of prostate cancer

摘要:

目的 分析动态增强磁共振成像（DCE-MRI）参数联合血清前列腺特异性抗原（PSA）水平对前列腺癌分化程度的鉴别价值。方法 回顾性分析2020年3月至2023年1月安阳市人民医院收治的148例前列腺癌患者的临床资料，患者均在治疗前行DCE-MRI检查及血清PSA水平检测。根据Gleason评分将前列腺癌患者分为低分化组（评分≥8分）和中高分化组（评分<8分），比较两组患者DCE-MRI参数［速率常数（K_ep）、转运常数（K^trans）、血管外细胞外容积分数（V_e）］和血清PSA水平，并采用受试者工作特征（ROC）曲线分析DCE-MRI参数联合血清PSA水平对前列腺癌分化程度的鉴别价值。结果 低分化组K_ep、K^trans及V_e和血清PSA水平均高于中高分化组（P<0.05）；DCE-MRI参数联合鉴别的灵敏度、特异度、曲线下面积（AUC）分别为85.00%、67.05%、0.793；DCE-MRI参数和血清PSA水平联合鉴别的灵敏度、特异度、AUC分别为80.00%、88.64%、0.872。结论 低分化前列腺癌相较于中高分化前列腺癌K_ep、K^trans、V_e和血清PSA水平更高，且上述指标联合鉴别效能良好，可在临床推广使用。

Abstract:

Objective To analyze the differential value of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) parameters combined with serum prostate specific antigen (PSA) level in differentiation of prostate cancer.Methods The clinical data of 148 prostate cancer patients admitted to Anyang People's Hospital from March 2020 to January 2023 were retrospectively analyzed, and they were all tested for DCE-MRI and serum PSA level before treatment. The prostate cancer patients were divided into poorly differentiated group (score ≥8 points) and moderately and well differentiated group (score <8 points) based on Gleason rating. The DCE-MRI parameters [rate constant (K_ep), transport constant (K^trans), extracellular volume fraction (V_e)] and serum PSA level in two groups were compared, and the receiver operating characteristic (ROC) curve was used to analyze the differential value of DCE-MRI parameters combined with serum PSA level in differentiation of prostate cancer.Results The K_ep, K^trans, V_e and serum PSA level in the poorly differentiated group were higher than those in the moderately and well differentiated group (P<0.05). The sensitivity, specificity and area under curve (AUC) of the combined identification of DCE-MRI parameters were 85.00%, 67.05% and 0.793, respectively. The sensitivity, specificity and AUC of the combined identification of DCE-MRI parameters and serum PSA level were 80.00%, 88.64% and 0.872, respectively.Conclusion The poorly differentiated prostate cancer has higher K_ep, K^trans, V_e and serum PSA level compared with moderately and well differentiated prostate cancer, and the combination identification of the above indicators has good effectiveness, which is suitable for clinical use.