| Aim:Analyzing the detection rate,sensitivity and specificity of peripheral zone prostate cancer by prostate biopsy under peripheral zone PI-RADS v2 score combined with traditional clinical indicators,and the correlation between peripheral zone PI-RADS v2 score and the traditional between clinical indicators of peripheral zone prostate cancer.Method:This study retrospectively analyzed the relevant clinical data of 129 patients who visited the First Affiliated Hospital of Jinan University from January 2014 to January 2020.All patients completed PSA-related examinations,multi-parameter magnetic resonance imaging examinations,and transrectal ultrasound systemic biopsy.Some patients also underwent MRI / ultrasound fusion targeted biopsy.All patients had a PI-RADS v2 score on the peripheral zone of the prostate by an imaging physician.Statistical analysis by SPSS 23 software:(1)using line × list chi-square test to analyze and compare the detection rate of prostate cancer(PCa)and clinically significant prostate cancer(cs PCa)under different peripheral zone PI-RADS v2 score;(2)Use the binary logistics analysis to calculate the probability of combining the PI-RADS v2 score of the peripheral zone with PSA,and make a receiver operating characteristic curve(ROC curve)to analyze the diagnostic efficiency,sensitivity and specificity of PI-RADS v2 score of the peripheral zone,PSA,and the combination of both in the examination of the prostate peripheral zone;(3)the two-way ordered attribute chi-square test was used to analyze the correlation and the respective coefficients between the PI-RADS v2 score and the traditional clinical indicators of PCa.Result:(1)The systemic biopsy under the guidance of rectal ultrasound show the detection rates of 100%,74.4%,28% and 16.7% for the peripheral zone PCa when the PI-RADS v2 score of the peripheral zone is at 5 points,4 points,3 points,and ≤ 2 points,of which the detection rate of cs PCa in the peripheral zone are 97.6%,71.8%,24% and 12.5%,respectively.While the MRI / ultrasound fusion targeted biopsy in the peripheral zone PI-RADS v2 scored at 5 points,4 points,3 points,and ≤ 2 points show the detection rates of PCa in the peripheral zone are 100%,46.7%,0% and 50%,of which the detection rates for cs PCa in the peripheral zone are 100%,46.7%,0% and 33.3%,respectively.(2)ROC curve analysis show that the area under the curve(AUC)values of PI-RADS v2 score combined with PSA for PCa and cs PCa in the peripheral zone are 0.926(95% CI: 0.880 ～ 0.971)and 0.931(95% CI: 0.887 ～ 0.975),respectively.At the best cutoff,the sensitivity are 80.2% and 80.5%,and the specificity are 95.8% and 96.2%,respectively.In MRI / ultrasound fusion targeted biopsy,the AUC values of PI-RADS v2 score combined with PSA for PCa and cs PCa are 0.935(95% CI: 0.860)～ 1.000)and 0.929(95% CI: 0.849 ～ 1.000),the sensitivity at the best cutoff point are 88.9% and 88.5%,and the specificity are 99.5% and 90.5%,respectively.(3)There is a correlation between the peripheral zone PI-RADS v2 score and the International Society of Urological Pathology(ISUP)grade of pathology,risk factor stratification of TNM stage,PSA stratification of the peripheral zone prostate cancer,and the correlation coefficients are 0.306,0.409 and 0.429,respectively.Conclusion:(1)The higher the PI-RADS v2 score of the peripheral zone,the higher the detection rate of the PCa and cs PCa in peripheral zone;but the detection rates of PCa and cs PCa by the MRI / ultrasound fusion targeted biopsy are still not satisfactory under the category 3 of the peripheral zone PI-RADS v2 score.(2)The PI-RADS v2 score in the peripheral zone combined with the PSA value can improve the diagnostic efficacy of PCa in the peripheral zone.(3)Peripheral zone PI-RADS v2 can reflect the rising trend of peripheral zone prostate cancer in ISUP grade,risk factor stratification of TNM stage and PSA,and can be used as an important reference for poor prognosis of prostate cancer. |
