肿瘤预防与治疗2023，Vol.36Issue(12)：1032-1039,8.DOI:10.3969/j.issn.1674-0904.2023.12.008
多参数MRI PI-RADS V2.1评分对前列腺癌的诊断效能分析
Efficacy of Multiparametric MRI PI-RADS V2.1 Scores in the Diagnosis of Prostate Cancer
摘要
Abstract
Objective:To evaluate the value of multiparametric MRI Prostate Imaging Reporting and Data System(PI-RADS)V2.1 scores in the diagnosis of prostate cancer.Methods:The data of 171 patients who underwent prostate multiparametric MRI(evaluated by PI-RADS V2.1 score)and prostate puncture/operation in our hospital from May 2020 to May 2023 were analyzed retrospectively.Taking the pathological results as the gold standard,the ROC curve was used to analyze the efficacy of PI-RADS scores in the diagnosis of prostate cancer.Spearman correlation coefficient was used to analyze the relationship between the PI-RADS V2.1 score and the Gleason score.The positive rates of prostate cancer in different PI-RADS scores were calculated,and the diagnosis of prostate cancer in different PI-RADS scores when prostate specific antigen(PSA)was between 4 ng/ml and 10 ng/ml was analyzed.Results:165 patients met the inclusion criteria.58 cases of prostatic carcinoma and 107 cases of benign prostatic hyperplasia were confirmed by pathology.The efficacy of PI-RADS V2.1 scores in the diagnosis of prostate cancer was evalu-ated by an ROC curve,with the AUC of 0.879,the Youden index of 0.688,the best cut-off value of 4,the sensitivity of 93.1%,the specificity of 75.7%,the accuracy of 81.8%,the positive predictive value of 67.5%,and the negative predictive value of 95.3%.There was a positive correlation between the PI-RADS V2.1 score and the Gleason score.Among the patients with PI-RADS scores of 5,4 and≤3,the positive rates of prostate cancer were 77.0%,36.8%and 4.7%,respectively.Among the prostate cancer patients whose PI-RADS score was 5,only 8.5%(4/47)of them scored 6 in Gleason score,while 91.5%(43/47)of them scored not less than 7;among those with PI-RADS score of 4,only 14.3%(1/7)scored 6 in Gleason score,while 85.7%(6/7)scored not less than 7;those with Gleason score of 6 accounted for 100%(4/4)of the prostate cancer patients whose PI-RADS score was not more than 3.Among those with PI-RADS scores of 5 and 4,32.5%(26/80)was diag-nosed as benign prostatic hyperplasia;and 78.6%(11/14)and 66.7%(8/12)of them further complicated with prostatitis.Among the 32 patients with PSA of 4～10 ng/ml,27 were diagnosed as benign prostatic hyperplasia and 5(15.6%)as prostate cancer.4 prostate cancer patients scored not less than 4 in PI-RADS V2.1 score,only 1 scored 3 in PI-RADS V2.1 score,and 6 in Gleason score.Conclusion:The multiparametric MRI PI-RADS V2.1 score has good diagnostic value for prostate cancer,the higher,the risk of clinically significant prostate cancer increases as the PI-RADS score increases.Prostatitis can easily lead to high PI-RADS score,affecting the diagnostic efficacy of PI-RADS score.When PSA is 4～10 ng/mL,the PI-RADS score can be used as an important rationale for puncture.关键词
多参数MRI/PI-RADS V2.1评分/前列腺癌/诊断价值Key words
Multiparametric MRI/PI-RADS V2.1 score/Prostate cancer/Diagnostic value分类
医药卫生引用本文复制引用
郑錦銳,李诗倩,粟宏伟,揭平平,尧麒..多参数MRI PI-RADS V2.1评分对前列腺癌的诊断效能分析[J].肿瘤预防与治疗,2023,36(12):1032-1039,8.基金项目
This study was supported by grants from Office of Sci-ence&Technology and Talent Work of Luzhou(No.2021LZXNYD-J34). 泸州市人民政府-西南医科大学科技战略合作项目(编号:2021LZXNYD-J34) （No.2021LZXNYD-J34）
泸州市科技计划项目(编号:2021LZXNYD-J34) （编号:2021LZXNYD-J34）
