The Value Of PSAMR Combined With PI-RADS V2 In The Diagnosis Of Prostate Cancer In Gray Area Of PSA

Objective:To explore the diagnostic value of prostate specific antigen mass ratio combined with prostate imaging report and data system version 2 in prostate cancer in gray area of PSA.Methods:The clinical data and auxiliary examination data of 118 cases of prostate puncture with definite pathological diagnosis were analyzed retrospectively.All patients were examined by multiparameter magnetic resonance before prostate puncture,and the concentration of serum PSA in all patients was 4-10ng/ml.The patients were divided into two groups,one group included 35 cases of prostate cancer,the other group included 83 cases of benign prostate disease.The age,BMI,blood volume,prostate volume,body surface area,PSAM,PSAMR and PI-RADS v2 of patients with prostate cancer and benign prostatic disease were compared.The independent predictors of prostate cancer in gray area were selected by multivariate analysis.The independent predictors of prostate cancer in gray area were selected by multivariate analysis.A logistic regression model was established to predict prostate cancer in grey area with independent predictors.The area under the curve(AUC)was calculated by using the working characteristic curve of subjects in the logistic regression model.The sensitivity and specificity of PSAMR and PI-RADS v2 in the diagnosis of prostate cancer in grey area of PSA were evaluated.Results:Among 118 patients with PSA concentration of 4-10ng/ml,83(70.34%)had benign prostatic lesions and 35(29.66%)had prostate cancer.There was significant difference in age,PSAM,PSAMR,PI-RADS v2,prostate volume,BMI,blood volume(P=0.002,0.023,0.000,0.000,0.000,0.001,0.045,P<0.05).The age,BMI,PSAMR and PI-RADS v2 of the two groups were compared by multivariate analysis.The results showed that the p-values of the age,BMI,PSAMR and PI-RADS v2 of the two groups were 0.004,0.377,0.000 and 0.002,respectively.There was no significant difference in the p-values of BMI>0.005 by multivariate analysis;PSAMR and PI-RADS v2 were independent predictors of prostate cancer in gray area.Combined with PSAMR and PI-RADS v2,a logistic regression model was established to predict prostate cancer in gray area.The formula of the model was:logit(P)=-4.03+0.924 PI-RADS v2+2.01 PSAMR;The area under ROC(area under ROC)was 0.732,0.81 and 0.888 for the diagnosis of gray area prostate cancer by the logistic regression model of PI-RADS v2,PSAMR and PSAMR in combination with PI-RADS v2.When the PSAMR threshold was 0.536,the sensitivity and specificity of gray prostate cancer were 94.3%and 57.8%;when the PI-RADS v2 threshold was 3.5,the sensitivity and specificity of gray prostate cancer were 74.1%and 73.5%;when the psamr+PI-RADS v2 threshold was 0.221,the sensitivity and specificity of gray prostate cancer were 91.4%and 79.5%.Conclusion:PSAMR combined with PI-RADS v2 can improve the sensitivity and specificity of the diagnosis of prostate cancer with PSA in the gray area.At the same time,PSAMR combined with PI-RADS v2 is of guiding significance for the patients with prostate disease with PSA in the gray area.