The Diagnostic Value Of Prostate Specific Antigen,MRI+MRS,Combined With Transrectal Ultrasound Prostate Biopsy On Prostate Cancer

Objective:To evaluate the significance of magnetic resonance imaging(MRI)in the diagnosis of PCa by assessing the consistency of MR examination and transrectal ultrasound(TRUS)-guided prostate biopsy.First,our study explored the clinical application value of MRI,TRUS-guided prostate biopsy with different prostate specific antigen(PSA).Second,the study explored the clinical application value of combination of the two methods.Third,through testing PSA,fPSA/t PSA,PSAD and MRI,this study analyzed the cancer detection rate(CDR)in gray zone,and paid closely attention on clinical significance of MRI for patients with PSA values in the gray zone,to increase the diagnosis accuracy of PCa and avoid unnecessary biopsy.Methods:We retrospectively analyzed 103 cases with complete clinical data,by setting the biopsy results as the standard group and the MR examination group as the experiment group.Then we analyzed the sensitivity and specificity of experiment group,and evaluated its value in diagnosing PCa with different PSA values.Concurrently,we concentrated on the data and clinical significance of MRI in the gray zone,and particularly analyzed its significance.Results: The detection rate of PCa by MRI is 48.5%,and its sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,Youden index were respectively 96.7%,71.2%,3.36,0.46 and 0.679.The CDR by biopsy was 29.1%.Moreover,the consistency between MRI findings and biopsy results were 80%,83.3%,72.2%,81.8% separately for patients with different PSA levels(4 groups).Among them,patients whose PSA is 4-10ng/ml or >20ng/ml was easier to find tumor by MRI.Furthermore,for patients in PSA gray zone,the sensitivity and specificity was separately 100% and 80% through the combination of MRI and biopsy.Moreover,the area under the ROC curve of fPSA/t PSA in diagnosing PCa of PSA gray zone was 0.125,and its corresponding sensitivity and specificity was 80% and 66.7%.Additionally,the PSAD value was significantly different from the so-called 0.15,the critical value(when P<0.05).Conclusions:The paper is the first to comprehensively analyze PCa detection in early stage through the combination of PSA,biopsy,and MRI.It is concluded that MRI have a high application value in the diagnosis of PCa,and the combination of MRI,MRS,PSA and prostate biopsy significantly increased the diagnostic efficiency in the diagnosis of PCa.Furthermore,MRIcan also help to reduce the false dismissal rate and unnecessary biopsies,especially for patients in the diagnostic gray zone with serum PSA between 4 and 10 ng/ml.