存在以下问题-第三军医大学学报.docVIP

磁共振波谱成像联合直肠指检及血清PSA在前列腺癌诊断中的应用研究 易强[基金项目]：河南省科技攻关项目（72102310106）;国家自然科学基金项目 [通讯作者]：宋东奎，Email：dksong@ ，王庆伟 NOTEREF _Ref309390142 \h \* MERGEFORMAT 1，车英玉2，张玉瑞 NOTEREF _Ref309390142 \h \* MERGEFORMAT 1，袁璞 NOTEREF _Ref309390142 \h \* MERGEFORMAT 1，杨小明 NOTEREF _Ref309390142 \h \* MERGEFORMAT 1，李琦 NOTEREF _Ref309390142 \h \* MERGEFORMAT 1，杨阳 NOTEREF _Ref309390142 \h \* MERGEFORMAT 1，师磊 NOTEREF _Ref309390142 \h \* MERGEFORMAT 1，宋东奎 NOTEREF _Ref309390142 \h \* MERGEFORMAT 1 (450052 郑州，郑州大学：第一附属医院泌尿外科1，第一附属医院磁共振室2) [摘要] 目的 初步探讨磁共振波谱成像（MRS）联合直肠指检（DRE）与血清前列腺特异抗原（PSA）在前列腺癌诊断中的应用。方法 选取血清PSA异常84例男性患者行前列腺MRS和DRE并与病理结果对照。分析MRS联合DRE与不同水平tPSA（低危组4ng/mlPSA10ng/ml，中危组10ng/mlPSA20ng/ml和高危组PSA20ng/ml）诊断前列腺癌的灵敏度（Se）、特异度（Sp）和准确度（AR）。结果 病理证实前列腺癌41例、非前列腺癌43例（良性增生41例，炎症1例，结核1例）。单纯MRS诊断前列腺癌的Se、Sp和AR分别为85.4%、83.7%和84.5%，与病理诊断有统计学一致性（K=0.69，P＜0.05）；MRS联合PSA低危组，中危组和高危组诊断的Se、Sp和AR分别为75.0%、90.0%和84.4%，66.7%、73.3%和71.4%，95.7%、87.5%和93.5%；MRS联合DRE诊断Se、Sp和AR分别为88.9%、87.5%和88.6%；MRS同时联合PSA高危组及DRE诊断Se、Sp和AR分别增加至95.7%、100%和95.8%，差异均有统计学意义（P＜0.05）。结论 MRS诊断前列腺癌具有无创和简便优点，其联合直肠指检及PSA有助于提高诊断的准确性。 [关键词] 磁共振波谱成像；前列腺肿瘤；前列腺特异性抗原；直肠指检 Significance of combining magnetic resonance spectroscopy with PSA and digital rectal examination in diagnosis of prostate cancer Yi Qiang1，Wang Qingwei1，Che Yingyu 2, Zhang Yurui1, Yuan Pu1, Yang Xiaoming1, Li Qi1, Yang Yang1, Shi Lei1, Song Dongkui1. (1Department of Urology, 2Department of MRI , the First Affiliated Hospital ,Zhengzhou University ,Zhengzhou ,450052,China.) [Abstract] Objective To preliminary study significance of combining magnetic resonance spectroscopy(MRS) with serum PSA and digital rectal examination(DRE) in prostate cancer(PCa) diagnosis. Methods A total of 84 male patients with abnormal serum PSA were enrolled and underwent further prostate MRS examination and DRE , contrasting with pathology obtained by prostate biopsy or transurethral resection of the prostate (TURP) . To evaluate the prostate cancer diagnos