The value of PSAD and CGPSAD combined mpMRI in the diagnosis of prostate cancer and hyperplasia in PSA gray zone / 西安交通大学学报(医学版)

ABSTRACT

【Objective】 To evaluate the diagnostic value of prostate specific antigen density (PSAD) and central glandular prostate specific antigen density (CGPSAD) combined with multi-parameter magnetic resonance imaging (mpMRI) in the diagnosis of prostate cancer (PCa) and prostate hyperplasia (BPH) in the gray area of prostate specific antigen (PSA) (4.0-10.0 μg/L). 【Methods】 Data of 634 patients who had received prostate biopsy in our hospital were retrospectively collected. Among them, 121 patients were selected. According to the pathological results of the biopsy, they were divided into PCa group and BPH group. The three diameters of the prostate and the central gland were measured by MRI. We calculated the prostate volume (PV) and the central gland volume (PVc), and then compared age, PSA, PV, PVc, PSAD, CGPSAD, prostate images, and PI-RADS score between PCa and BPH groups. Multifactor logistic regression analysis was performed to study the independent risk factors for PCa. Receiver operating characteristic (ROC) curves of PCa diagnosis were plotted, respectively, and the area under the curve (AUC) was calculated and compared with the reference. 【Results】 There was no significant difference in total prostate specific antigen (tPSA) between the two groups (P>0.05). However, significant differences were observed in age, PV, PVc, PSAD, CGPSAD and PI-RADS score between the two groups (P<0.05). Multifactor logistic regression analysis showed that PI-RADS score was an independent risk factors for PCa (OR=4.156, P<0.001). The AUC value of PSAD, CGPSAD, PI-RADS score, PSAD combined with PI-RADS score and CGPSAD combined with PI-RADS score were 0.744, 0.771, 0.844, 0.884, and 0.903, respectively. The AUC value of CGPSAD combined PI-RADS score was the highest. 【Conclusion】 CGPSAD is better than PSAD in diagnosing PCa in the grey area of PSA. Combined with PI-RADS score of mpMRI, it can improve the diagnosis of prostate cancer and guide clinical and prostate biopsy.