mpMRI、TRUS及二者联合检查在前列腺恶性肿瘤诊断的应用价值初步分析

Preliminary Analysis of the Application Value of mpMRI, TRUS, and the Joint-Examination in the Diagnosis of Prostate Malignant Tumors

摘要: 目的：探讨在前列腺恶性肿瘤患者中经直肠超声(TRUS)、多参数磁共振(mpMRI)检查及二者联合检查对其进行诊断的应用价值。方法：回顾性分析2016年10月~2023年6月在青岛大学附属医院收治疑似为前列腺恶性肿瘤的患者143例，以手术或穿刺活检获得的病理结果作为诊断金标准，分析和对比TRUS、MRI及联合检查方法对前列腺恶性肿诊断的准确率以及灵敏度、特异度，初步评估检查方法诊断前列腺恶性肿瘤的应用价值。结果：MRI、TRUS检查分别对比联合检查方法统计学具有差异性(P < 0.05)。MRI作为单一检查方法，符合诊断105例，假阳性患者12例，假阴性患者26例，诊断准确率为73.4%，灵敏度为72.9%，特异性为74.4%，AUC为0.74。TRUS作为单一检查方法，符合诊断100例，假阳性患者11例，假阴性患者32例，诊断准确率为69.9%，灵敏度为68.8%，特异性为76.6%，AUC为0.72。联合检查方法，符合诊断117例，假阳性患者12例，假阴性患者14例，诊断诊断准确率为81.8%，灵敏度为85.4%，特异性为74.4%，AUC为0.80。MRI、TRUS及联合检查AUC值差异具有显著性(P < 0.05)。结论：TRUS、mpMRI及二者联合检查都可用于前列腺恶性肿瘤的诊断，联合检查则综合利用了两者的优势，可提高诊断准确性。

Abstract: Objective: To explore the diagnostic value of transrectal ultrasound (TRUS), multiparametric magnetic resonance imaging (mpMRI), and their joint-examination in patients with prostate cancer. Method: A retrospective analysis was conducted on 143 patients suspected of prostate malignant tumors admitted to Qingdao University Affiliated Hospital from October 2016 to June 2023. The pathological results obtained from surgery or biopsy were used as the diagnostic gold standard. The accuracy, sensitivity, and specificity of TRUS, MRI, and joint-examination method in the diagnosis of prostate malignant tumors were analyzed and compared, and the application value of the examination methods in the diagnosis of prostate malignant tumors was preliminarily evaluated. Result: There was a statistically significant difference (P < 0.05) between MRI and TRUS examinations compared to the combined examination method. As a single examination method, 105 cases were diagnosed as positive in MRI, with 12 false positive cases and 26 false negative cases. The diagnostic accuracy was 73.4%, sensitivity was 72.9%, specificity was 74.4%, and AUC was 0.74. As a single diagnostic method, 100 cases were predicted in TRUS, with 11 false positive patients and 32 false negative patients. The diagnostic accuracy was 69.9%, sensitivity was 68.8%, specificity was 76.6%, and AUC was 0.72. The joint-examination method confirmed the diagnosis of 117 cases, including 12 false positive patients and 14 false negative patients. The diagnostic accuracy was 81.8%, sensitivity was 85.4%, specificity was 74.4%, and AUC was 0.80. There was a significant difference in AUC values among MRI, TRUS, and joint-examination (P < 0.05). Conclusion: TRUS, mpMRI, and the joint-examination can all be used for the diagnosis of prostate malignant tumors. The combined examination comprehensively utilizes the advantages of both and can improve diagnostic accuracy.