Sim Ki Choon, Sung Deuk Jae, Kang Kun Woo, Yang Kyung Sook, Han Na Yeon, Park Beom Jin, Kim Min Ju, Cho Sung Bum
From the *Departments of Radiology, Anam Hospital, and †Department of Biostatistics, College of Medicine, Korea University, Seoul, Korea.
J Comput Assist Tomogr. 2017 Sep/Oct;41(5):731-736. doi: 10.1097/RCT.0000000000000579.
The aim of this study was to assess the utility of prostate-specific antigen density (PSAD) calculated using magnetic resonance imaging for predicting Gleason score (GS) upgrade in patients with low-risk prostate cancer on biopsy.
Seventy-three patients were divided into 2 groups according to the concordance between biopsy and prostatectomy GS: group 1 (6/6) and group 2 (6/≥7). Magnetic resonance imaging-based PSAD, prostate volume, prostate-specific antigen (PSA), and age were compared between the 2 groups. Logistic regression and receiver operating characteristic curve analysis were performed.
Gleason score was upgraded in 40 patients. Patients in group 2 had significantly higher PSAD and PSA values and smaller prostate volume than did those in group 1. Prostate-specific antigen density of 0.26 ng/mL per cm or higher, PSA of 7.63 ng/mL or higher, and prostate volume of 25.1 cm or less were related to GS upgrade, with area-under-the-curve values of 0.765, 0.721, and 0.639, respectively.
Magnetic resonance imaging-based PSAD could help in predicting postoperative GS upgrade in patients with low-risk prostate cancer.
本研究旨在评估利用磁共振成像计算的前列腺特异性抗原密度（PSAD）对活检时低风险前列腺癌患者 Gleason 评分（GS）升级的预测效用。
根据活检与前列腺切除术后 GS 的一致性，将 73 例患者分为 2 组：第 1 组（6/6）和第 2 组（6/≥7）。比较两组基于磁共振成像的 PSAD、前列腺体积、前列腺特异性抗原（PSA）和年龄。进行逻辑回归和受试者工作特征曲线分析。
40 例患者 Gleason 评分升级。第 2 组患者的 PSAD 和 PSA 值显著高于第 1 组，前列腺体积小于第 1 组。PSAD 为 0.26 ng/mL 每立方厘米或更高、PSA 为 7.63 ng/mL 或更高以及前列腺体积为 25.1 立方厘米或更小与 GS 升级相关，曲线下面积值分别为 0.765、0.721 和 0.639。
基于磁共振成像的 PSAD 有助于预测低风险前列腺癌患者术后 GS 升级。
