多参数磁共振成像联合四基因模型提高前列腺癌早期诊断效能的临床研究
冼土增1，张俊夫1，罗飞2，张添辉3，陈征1，江东根1，黄群雄1，王劲3，高新1，庞俊4

510630 广州，中山大学附属第三医院泌尿外科1，内分泌科2，放射科3；518107 深圳，中山大学附属第七医院泌尿外科4

前列腺癌;诊断;磁共振;基因模型

The clinical research of multi-parametric magnetic resonance imaging combined with four-gene model to improve the early diagnostic efficacy of prostate cancer
Xian Tuzeng1, Zhang Junfu1, Luo Fei2, Zhang Tianhui3, Chen Zheng1, Jiang Donggen1, Huang Qunxiong1, Wang Jin3, Gao Xin1, Pang Jun4.

1Department of Urology, 2Department of Endocrinology, 3Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China; 4Department of Urology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China

Prostate cancer; Diagnosis; Magnetic resonance imaging; Gene model

DOI: 10.3877/cma.j.issn.1674-3253.2018.03.002

备注

目的 探究多参数磁共振成像（MP-MRI）联合外周血四基因模型（ITGB5，ERG，TIMP1，TMEM176B）对前列腺癌（PCa）成像的早期诊断效能。方法 建立外周血四基因 PCa诊断模型，对 363例疑似 PCa患者进行 MP-MRI检查和外周血四基因检测（结果只判定阳性或阴性），以前列腺穿刺活检或术后病理结果为金标准，计算 MP-MRI、四基因模型、MP-MRI联合四基因模型诊断 PCa的灵敏度、特异度、阳性预测值和阴性预测值。结果 四基因模型单独诊断 PCa具有较高的灵敏度（99.0 %）和阴性预测值（97.9 %）。相比 MP-MRI或四基因模型单独诊断 PCa的效能，MP-MRI联合四基因模型能显著提高诊断 PCa的特异度（86.4 %）和阳性预测值（87.5 %）。结论 四基因模型及 MP-MRI联合四基因模型是诊断 PCa的比较理想的方法，对 PCa的早期诊断显示出良好的临床应用前景。
Objective To investigate the early diagnostic efficacy of multi-parametric magnetic resonance imaging (MP-MRI) combined with four-gene model (ITGB5, ERG, TIMP1, TMEM176B) of peripheral blood for prostate cancer (PCa). Methods A four-gene diagnostic model of peripheral blood for prostate cancer was firstly established. Then, MP-MRI examination and four-gene detection of peripheral blood were taken in 363 patients with suspected prostate cancer (the results were positive or negative). The prostate biopsy or postoperative pathological results were taken as the gold standard. The sensitivity, specificity, positive predictive value and negative predictive value were calculated for MP-MRI, four-gene model, MP-MRI combined with four-gene model in the diagnosis of prostate cancer, respectively. Results The four-gene model alone has higher sensitivity (99.0%) and negative predictive value (97.9%) in the diagnosis of PCa. MP-MRI combined with the four-gene model significantly increased the diagnostic specificity (86.4%) and the positive predictive value (87.5%) for PCa compared with MP-MRI alone or four-gene model alone. Conclusion s Four-gene model and MP-MRI combined with four-gene model are ideal methods in the diagnosis of prostate cancer, showing good clinical application prospects for the early diagnosis of prostate cancer.
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