岭南现代临床外科2025，Vol.25Issue(3)：196-201,6.DOI:10.3969/j.issn.1009-976X.2025.03.009
联合MRI-DWI及PSAD预测前列腺癌分化程度的价值
Value of MR-DWI combined with PSAD on differentiation degree of prostate cancer
摘要
Abstract
Objective To investigate the value of 3.0T magnetic resonance diffusion weighted imaging(MR-DWI)parameters combined with prostate-specific antigen density(PSAD)on predicting the differ-entiation degree of prostate cancer.Methods 80 patients with prostate cancer in the hospital from August 2021 to August 2024 were included in this study.According to the results of clinical and pathological examination,they were divided into 32 cases in highly differentiated group(Gleason score<7 points)and 48 cases in moderately and poorly differentiated group(Gleason score≥7 points).The MR-DWI signs,apparent diffusion coefficient(ADC)under different b values(0 s/mm2,1000 s/mm2)and PSAD were analyzed and compared.The correlation between ADC,PSAD and Gleason score was analyzed.Receiver operating characteristic(ROC)curve was used to analyze the evaluation value of ADC and PSAD on differentiation degree of prostate cancer.Results Compared with highly differentiated group,the proportions of cases with blurred lesion boundary and lesion located in peripheral zone by MR-DWI were more in moderately and poorly differentiated group(P<0.05).The ADCs under different b values in mod-erately and poorly differentiated group were smaller than those in highly differentiated group,and PSAD was higher than that in highly differentiated cancer group(P<0.05).ADC was negatively correlated with Gleason score(P<0.05),and PSAD was positively correlated with Gleason score(P<0.05).The results of the ROC curve analysis for assessing the risk of low-to-intermediate-grade prostate cancer showed that the areas under the curve(AUCs)for the ADC value(b=50 s/mm2),the ADC value(b=1200 s/mm2),the PSAD level,and the combined model were 0.747,0.704,0.700,and 0.890,respectively.Statistical comparison indicated no significant difference in diagnostic performance among the three individual indi-cators(P>0.05).However,the diagnostic performance of the combined model was significantly superior to that of any single indicator(Z-scores=2.662,3.190,and 2.593,respectively;all P<0.05).Among all assessment models,the combined model demonstrated the highest diagnostic efficacy,with a sensitivity of 66.67% and a specificity of 96.87%.Conclusion Both ADC values and PSAD levels are effective biomarkers for assessing the differentiation grade of prostate cancer.A multiparametric model,constructed by combining MR-DWI-derived ADC values with serum PSAD levels,demonstrates superior diagnostic performance in the preoperative prediction of low-to-intermediate-grade prostate cancer risk compared to each individual indicator.关键词
磁共振扩散成像/表观扩散系数/前列腺特异性抗原密度/前列腺癌/分化程度Key words
magnetic resonance diffusion imaging/apparent diffusion coefficient/prostate-specific antigen density/prostate cancer/differentiation degree分类
医药卫生引用本文复制引用
张丽花,张珂,袁嘉俊..联合MRI-DWI及PSAD预测前列腺癌分化程度的价值[J].岭南现代临床外科,2025,25(3):196-201,6.基金项目
南通市科技局社会民生科技计划项目(编号:20231018875) （编号:20231018875）
