DCE-MRI参数对比改良Gleason评分、PSA预测前列腺癌患者
治疗后去势抵抗性前列腺癌的风险性

doi:10.12117/jccmi.2018.11.009

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Abstract Objective: To investigate the role of the DCE-MRI parameters, the modified Gleason score, and PSA in predicting the risk of castration resistant prostate cancer after prostate cancer treatment, and to provide evidence for clinical treatment. Methods: From August 2009 to August 2015, 193 patients with prostate cancer were treated in our hospital, and their age, DCE-MRI parameter, modified Gleason score, PSA, BMI and TNM staging were recorded. All patients were followed up for 2 years, the single factor analysis was used to analyzed the factors affecting the prognosis of patients with prostate cancer. The Cox regression model was used to further analyze the prognostic impact of prostate cancer on the severity of the disease. T test was used to show the differences in the distribution of prostate cancer risk factors between the two groups. The sensitivity and specificity of Ktrans and PSA levels in predicting the risk of castration resistant prostate cancer after treatment for prostate cancer were analyzed using the ROC curve. Results: Univariate analysis showed that age, improved Gleason score, PSA, DCE-MRI parameters, and TNM staging all affected the prognosis of the patients, and the difference was statistically significant(P<0.05). The results of Cox regression indicated that the DCE-MRI parameter, Ktrans value(P=0.027) and PSA value(P=0.028) had significant influence on the risk of CRPC, and the influence of Ktrans value was higher than that of PSA(RR=2.413 vs RR=2.012). The t test showed that the Ktrans value in the poor prognosis group was significantly higher than that in the good prognosis group(P=0.001). The level of PSA in the poor prognosis group was higher than that in the good prognosis group(P=0.024). Under the ROC curve, the AUC of Ktrans value was 0.843(95% confidence interval: 0.769 to 0.917), and the sensitivity and specificity were 82.14% and 71.43% respectively. The AUC of PSA level was 0.752(95% confidence interval: 0.657 to 0.847), and the sensitivity and specificity were 74.92% and 63.42% respectively. Conclusion: The DCE-MRI parameter Ktrans is a better predictor of CRPC in patients with prostate cancer after treatment and is expected to serve as a routine indicator of prostate cancer, to provide a basis for clinical treatment.

Key words： Prostatic neoplasms Orchiectomy Magnetic resonance imaging

Received: 05 December 2017

PACS:	Ｒ737.25
	Ｒ445.2

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	Articles by authors
	YAO Xiao-gang1
	ZHU Pei-ju2
	ZHAO Ming1
	HUANG Yu-nong1
	CHEN Jing1

Cite this article:

YAO Xiao-gang1,ZHU Pei-ju2,ZHAO Ming1, et al. Comparison of DCE-MRI parameters, modified Gleason score and PSA in predicting the risk of castration resistant prostate cancer in prostate cancer patients after treatment[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(11): 803-807.

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http://www.jccmi.com.cn/EN/10.12117/jccmi.2018.11.009 OR http://www.jccmi.com.cn/EN/Y2018/V29/I11/803

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