Predictive value of PSAMR combined with PI-RADS v2 score in high-grade prostate cancer

Abstract

Abstract:

ObjectiveTo explore the predictive value of prostate specific antigen mass ratio (PSAMR) combined with prostate imaging reporting and data system version 2 (PI-RADS v2) score for high-grade prostate cancer.MethodsThe clinical data and auxiliary examination data of 207 patients with prostate biopsy and definite pathological diagnosis in the Affiliated Hospital of Panzhihua University from June 2017 to June 2020 were retrospectively analyzed. All patients were taken blood for prostate specific antigen (PSA), and underwent multi parameter magnetic resonance imaging and prostate biopsy. According to the gold standard of pathological biopsy diagnosis, all patients were divided into two groups: high-grade prostate cancer group (n=95) and non-high-grade prostate cancer group (n=112) (including 26 cases of low-grade prostate cancer and 86 cases of benign prostate disease). The patient's age, prostate volume, PSA, prostate specific antigen density (PSAD), PSAMR and PI-RADS v2 score in the two groups were compared. The independent predictors of high-grade prostate cancer were selected by multivariate analysis. Logistic regression model with independent predictors was established for the prediction of high-grade prostate cancer. Receiver operating characteristic (ROC) curve was used to analyze the predictive value, and the area under the curve (AUC) was calculated.ResultsIn the high-grade prostate cancer group and non-high-grade prostate cancer group, the ages of patients were (77.34±7.76) years and (67.96±7.02) years, and there was a statistically significant difference (t=4.02,P<0.001); the prostate volumes were (44.00±15.31) cm³and (63.90±28.45) cm³, and there was a statistically significant difference (t=19.05,P<0.001); the PSA levels of patients were (35.42±12.90) μg/L and (18.85±8.69) μg/L, and there was a statistically significant difference (t=6.55,P<0.001); the PSAD of patients were (0.86±0.36) μg/(L·cm³) and (0.32±0.13) μg/(L·cm³), and there was a statistically significant difference (t=12.85,P<0.001); the PSAMR of patients were 4.71±0.30 and 1.79±0.13, and there was a statistically significant difference (t=9.23,P<0.001); the PI-RADS v2 scores were 4.31±0.88 and 2.73±0.87, and there was a statistically significant difference (t=6.12,P=0.001). Logistic regression analysis showed that there were statistically differences in age, PSA, prostate volume, PSAMR, PSAD and PI-RADS v2 scores (allP<0.05). The AUC value of PSAMR in predicting high-grade prostate cancer was 0.834 (threshold value was 2.480,P<0.001), the sensitivity was 0.804, and the specificity was 0.726. The AUC value of PI-RADS v2 score was 0.874 (threshold value was 3.500,P<0.001), the sensitivity was 0.800, and the specificity was 0.821. The AUC value of PSAMR combined with PI-RADS v2 score was 0.922 (threshold value was 0.690,P<0.001), the sensitivity was 0.995, and the specificity was 0.758.ConclusionPSAMR combined with PI-RADS v2 score can improve the diagnostic efficiency for predicting high-grade prostate cancer.

Key words:Prostatic neoplasms,Prostate specific antigen,Prostate imaging reporting and data system version 2

Ji Chundong, Liu Kai, Feng Yue, Wang Fei, Yang Jun, Xue Rongbo. Predictive value of PSAMR combined with PI-RADS v2 score in high-grade prostate cancer[J]. Journal of International Oncology, 2020, 47(12): 723-727.

Figures/Tables5

参数	轴位T2WI	冠状位T2WI	矢状位T2WI	轴位DWI	轴位DCE-MRI
序列	FSE	FSE	FSE	EPI	LAVA
TR(ms)	3 500	3 500	3 500	2 800~3 100	3 300
TE(ms)	115.0	115.0	115.0	53.5~60.0	22.0
FOV(cm)	20.0×20.0	24.0×24.0	26.0×26.0	30.0×30.0	36.0×36.0
NEX	4.0	4.0	4.0	8.0	0.8
层厚(mm)	4.0	4.0	4.0	4.0	2.6
层间距(mm)	0.0	0.0	0.0	0.0~0.5	2.6

组别	年龄(岁)	PSA(μg/L)	前列腺体积 (cm³)	PSAMR	PSAD [μg/(L·cm³)]	PI-RADS v2 评分(分)
高级别前列腺癌组(n=95)	77.34±7.76	35.42±12.90	44.00±15.31	4.71±0.30	0.86±0.36	4.31±0.88
非高级别前列腺癌组(n=112)	67.96±7.02	18.85±8.69	63.90±28.45	1.79±0.13	0.32±0.13	2.73±0.87
t值	4.02	6.55	19.05	9.23	12.85	6.12
P值	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001

变量	OR值	95%CI	P值
年龄	0.91	0.89~0.96	0.001
PSA	9.73	8.89~10.66	0.005
前列腺体积	1.06	1.00~1.11	0.003
PSAMR	8.40	4.10~17.2	0.006
PSAD	3.38	1.00~12.3	0.007
PI-RADS v2评分	2.35	1.48~3.80	<0.001

变量	阈值	AUC	特异性	敏感性	P值
PSA	32.270	0.736	0.495	0.866	<0.001
PSAD	0.420	0.833	0.737	0.768	<0.001
PSAMR	2.480	0.834	0.726	0.804	<0.001
PI-RADS v2 评分	3.500	0.874	0.821	0.800	<0.001
PSAMR+ PI-RADS v2评分	0.690	0.922	0.758	0.995	<0.001

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