Diagnostic Value Of Multi-parameter Magnetic Resonance PIRADS V2 Score Combined With PSAD In Prostate Cancer

Objective:To explore the multi-parametric magnetic resonance imaging(mp-MRI)PI-RADS V2(prostate imaging reporting and data system)score combined with prostate specific antigen density(prostate specific antigen density,PSAD)for the diagnosis of prostate cancer(PCa).Methods:The clinical data of 670 patients undergoing ultrasound-guided prostate puncture from January 2015 to June 2019 in the Department of Urology,Second Affiliated Hospital of Kunming Medical University were retrospectively analyzed.The PIRADS V2 score,PSAD and tPSA,fPSA/tPSA,and prostate volume were collected and sorted before puncture.According to the pathological results afPSA/tPSAer prostate puncture,the patients were divided into prostate cancer combined non-cancer groups,and the differences between the two groups were analyzed.The univariate and multivariate logistic regression analysis was used to analyze the PIRADS score,PSAD and tPSA,fPSA/tPSA,and prostate.The value of volume in diagnosis of prostate cancer.Results:A total of 670 patients were enrolled,including 377 in the PCa group and 315 in the non-cancer group.In the univariate analysis,except for the fPSA/tPSA ratio,there were significant differences in various indicators between patients with non-prostate cancer and patients with prostate cancer(P<0.05).Multivariate logistic regression analysis suggested that tPSA(ng/ml),prostate density(ng/ml/cm*3),and PIRADS V2 scores were independent predictors of prostate cancer.The AUC of PI-RADS V2 for prostate cancer diagnosis was 0.871,and the sensitivity,specificity,and Youden index for diagnosis of prostate cancer were 75.74,84.50,and 0.6024.The auc of PSAD in the diagnosis of prostate cancer was 0.610,and the sensitivity,specificity,and Youden index for the diagnosis of prostate cancer were 56.72,61.99,and 0.1871.The auc for tPSA diagnosis of prostate cancer was 0.795,and the sensitivity,specificity,and Youden index for diagnosis of prostate cancer were 81.64,64.41,and 0.4605.The PI-RADS V2 score,PSAD.and tPSA were used to diagnose prostate cancer.It was found that the PI-RADS V2 score+PSAD had the highest auc,which was 0.919.The sensitivity,specificity,and accuracy were 88.33,87.94,and 88.13,both The combination can effectively improve the positive rate of prostate cancer diagnosis.For grey area PSA patients,the summer area of the ROC curve of PI-RADS V2 and PSAD is 0.864,0.844,and the Jordan index is 0.4605,0.5669,respectively.PI-RADS V2 combined with PSAD had the highest auc in diagnosing prostate cancer,which was 0.926.The sensitivity,specificity,and accuracy were 91.18 and 86.2187.33.It shows that PI-RADS V2 and PSAD are independent predictors of gray-area prostate cancer,and their combined use can improve the positive rate of prostate cancer diagnosis.Conclusion:PI-RADS V2 has a good diagnostic effect on prostate cancer.PI-RADS V2 combined with PSAD can improve the diagnosis rate of gray-area prostate cancer.