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在良性前列腺阻塞患者中进行前列腺活检的最佳PSA密度值,这些患者的PSA水平较高,但MRI结果为负
Yiji Peng1, Chengcheng Wei2, Ying Li3
1Department of Urology, Southwest Hospital, Army Medical University, (Third Military Medical University), No.30 Gaotanyan Street, Shapingba District, Chongqing, 400038, China.
在良性前列腺增生患者中,PSA升高和MRI阴性,PSA密度 (PSAD) 是前列腺癌的关键预测因素. 0.30 ng/ml/cm3的PSAD值可以指导活检决策,可能减少不必要的程序.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
背景情况:
- 在良性前列腺增生症 (BPH) 患者中,前列腺特异性抗原 (PSA) 升高,具有负的多参数核磁共振 (MRI) 呈现出诊断挑战.
- 准确的风险分层对于避免不必要的前列腺活检和相关并发症至关重要.
研究的目的:
- 确定可靠的临床参数,以指导BPH患者的前列腺活检决策,这些患者的PSA升高和MRI阴性.
- 在这个特定的患者队列中开发和验证前列腺癌 (PCa) 检测的预测模型.
主要方法:
- 对接受手术的318名BPH患者的临床和病理数据的回顾性分析.
- 评估参数包括年龄,PSA,自由/总PSA比率 (F/T PSA),前列腺体积和PSA密度 (PSAD).
- 在模型开发和验证中应用后勤回归,ROC分析和决策曲线分析 (DCA).
主要成果:
- 在8.2%的患者中诊断出前列腺癌.
- PSA 密度 (PSAD) 成为PCa.唯一的独立预测指标.
- 预测模型和PSAD显示出高的诊断准确性 (AUC分别为0.855和0.848),表现优于PSA和F/T PSA比率.
- DCA建议,在做生检决定时,PSAD的最佳值为0.30 ng/ml/cm3.
结论:
- 建议PSAD值为0.30 ng/ml/cm3,以帮助在BPH患者的活检决策中提高PSA和负MRI.
- 这种方法可以减少不必要的活检,并发症,住院和医疗费用.
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