The Diagnostic Value Of PI-RADS V2 Combined With Prostate Specific Antigen And Its Derivatives In Prostate Cancer

Objective:To assess the diagnostic value of the Prostate Imaging Reporting and Data System version 2.0(PI-RADS v2)scoring system combined with prostate specific antigen and its derivatives in prostate cancer.Methods : 177 Prostate patients who had biopsy or surgical pathology results,were analyzed retrospectively between January 2014 and October 2017 in the Affiliated Hospital of Chengdu University.Clinical variables included PI-RADS v2 scores,total PSA(tPSA),free PSA(fPSA),f/t PSA,PSAD and Gleason scores.The independent sample t test with SPSS software was used to analyze these parameters of prostate cancer group and non prostate cancer group.The unconditional logistic regression was performed to determine significant predictors of prostate cancer.Logistic regression models were established with predictors.The area under the curve(AUC)of the receiver operating characteristic(ROC)was employed to evaluate the diagnostic efficiency of model and each parameter.The z test was applied to validate the difference between the model group and the single factor.Results:In all,63(35.6%)of the 177 patients were diagnosed with prostate cancer,114(64.4%)patients were diagnosed without prostate cancer.The independent sample t test showed that all factors(t PSA,fPSA,f/t PSA,PSAD and PI-RADS v2 score)were significantly different between prostate cancer group and non prostate group.The area under the curve(AUC)of the receiver operating characteristic(ROC)showed that PSAD had highest diagnosis accuracy(AUC=0.89,95%CI:0.83~0.93,P?0.05)in prostate cancer.The unconditional logistic regression analysis revealed that PI-RADS v2 score and PSAD were independent predictors of prostate cancer.The area under the curve(AUC)of the logistic regression model of prostate cancer was 0.91(95%CI:0.86~0.96)and the threshold was 0.28.The equation of the logistic regression: Logit P= ? 4.90+0.58 ×PSAD+1.14×PI-RADS v2.Conclusions:(1)PI-RADS V2 score and PSAD are independent factors of PCa;(2)the Logistic regression prediction model combined with PI-RADS v2 score and PSAD has a high diagnostic efficiency,which can guide the selection of patients with prostate biopsy.