国际医学放射学杂志2026，Vol.49Issue(1)：58-63,6.DOI:10.19300/j.2026.L22240
MRI在活检Gleason评分为6的前列腺癌中检测临床显著前列腺癌的价值
Value of MRI in detecting clinically significant prostate cancer in patients with biopsy Gleason score 6
杨惠娅 1沈丽萍 1陈建新 1张同华2
作者信息
- 1. 张家港市第一人民医院影像科,张家港 215600
- 2. 皖南医学院第二附属医院放射影像科
- 折叠
摘要
Abstract
Objective To explore the value of multiparametric MRI(mpMRI)in detecting clinically significant prostate cancer(csPCa)in patients with biopsy Gleason score 6 prostate cancer.Methods A retrospective study was conducted including 110 patients with biopsy-confirmed prostate cancer and a Gleason score of 6.The mean age was 72.3±7.2 years.All patients underwent mpMRI prior to prostate biopsy,and lesions were assessed using the Prostate Imaging Reporting and Data System(PI-RADS)version 2.1.Postoperative pathological findings served as the reference standard for csPCa,defined according to the Epstein criteria.Patients were divided into csPCa and non-csPCa groups.Clinical and imaging variables were compared using the Mann-Whitney U test,chi-square test,or Fisher's exact test,as appropriate.Variables showing statistical significance were entered into multivariate logistic regression analysis to identify independent predictors of csPCa.Receiver operating characteristic(ROC)curve analysis was performed to evaluate diagnostic performance,and the area under the curve(AUC)was calculated.Results Among the 110 patients,92(83.6%)were confirmed to have csPCa on postoperative pathology.Compared with the non-csPCa group,patients in the csPCa group had significantly larger tumor diameters and a higher proportion of tumor stage≥T3 and PI-RADS scores≥4(all P<0.05).Multivariate logistic regression analysis identified tumor diameter as the only independent predictor of csPCa(P<0.05).ROC analysis demonstrated that tumor diameter showed the highest diagnostic performance(AUC=0.90),followed by PI-RADS v2.1 score(AUC=0.75)and tumor stage≥T3(AUC=0.63).Tumor diameter achieved the highest sensitivity(95.65%),accuracy(92.52%),and negative predictive value(73.33%),whereas tumor stage≥T3 demonstrated the highest specificity and positive predictive value(both 100%).Conclusion mpMRI is valuable for detecting potential csPCa in patients with biopsy Gleason score 6 prostate cancer.关键词
磁共振成像/前列腺影像报告和数据系统/前列腺癌/Gleason评分/临床显著前列腺癌Key words
Magnetic resonance imaging/Prostate imaging reporting and data system/Prostate cancer/Gleason score/Clinically significant prostate cancer分类
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杨惠娅,沈丽萍,陈建新,张同华..MRI在活检Gleason评分为6的前列腺癌中检测临床显著前列腺癌的价值[J].国际医学放射学杂志,2026,49(1):58-63,6.
