磁共振成像联合血清前列腺特异抗原、上皮钙黏蛋白、早期前列腺癌抗原-2诊断前列腺癌的临床价值探讨

摘要 目的：探究磁共振成像（MRI）联合血清前列腺特异抗原（PSA）、上皮钙黏蛋白（sE-cadherin）、早期前列腺癌抗原-2（EPCA-2）诊断前列腺癌的临床价值。方法：选取潍坊市人民医院2020年1月-2021年7月期间经病理证实的50例前列腺癌患者（前列腺组）以及50例前列腺增生患者（前列腺增生组）展开回顾性研究。100例研究对象均完善了MRI检查并测定血清PSA、EPCA-2、sE-cadherin水平，分析两组患者的MRI影像学特征，比较两组患者的PSA、EPCA-2、sE-cadherin水平以及各项检查方法的诊断准确性差异。结果：前列腺癌的MRI影像学特征为病灶主要位于外周带，外周带T2W呈低信号，病变侵及包膜、膀胱及周围组织具有T1加权消失或者不对称，具有信号异常、肌肉增厚的表现，盆腔淋巴结转移具有淋巴结部分融合或增大表现；前列腺增生的MRI影像学特征为边界清晰、包膜完整并且中央带增生、不均匀信号结节；前列腺癌、前列腺增生均存在不同程度的前列腺体积增大。相比于前列腺增生组，前列腺癌组患者的PSA、sE-cadherin、EPCA-2水平明显更高（P<0.05）。MRI、PSA、sE-cadherin、EPCA-2四项联合鉴别前列腺癌、前列腺增生的诊断符合率为96.00%，明显高于四项单独诊断的88.00%、79%、81%、82%（P<0.05）。结论：MRI联合PSA、sE-cadherin、EPCA-2鉴别诊断前列腺癌的准确性较高，具有作为临床前列腺癌早期诊断指导方案的潜力。

Discussion on Clinical Value of Magnetic Resonance Imaging Combined with Serum Prostate Specific Antigen, Epithelial Cadherin and Early Prostate Cancer Antigen 2 in Diagnosis of Prostate Cancer

ABSTRACT Objective: To investigate the clinical value of magnetic resonance imaging (MRI) combined with serum prostate specific antigen (PSA), epithelial cadherin (SE-cadherin) and early prostate cancer antigen-2 (EPCA-2) in the diagnosis of prostate cancer. Methods: A retrospective study was conducted on 50 pathologically confirmed patients with prostate cancer (prostate group) and 50 patients with prostatic hyperplasia (prostate hyperplasia group) in Weifang people''s Hospital from January 2020 to July 2021. All 100 subjects underwent MRI examination and serum PSA, EPCA-2 and sE-cadherin levels were determined. MRI imaging characteristics of patients in the two groups were analyzed, and the differences in the diagnostic accuracy of PSA, EPCA-2 and sE-cadherin levels and various examination methods were compared between the two groups. Results: The MRI features of prostate cancer were that the lesions were mainly located in the peripheral zone, and the peripheral zone showed low signal intensity on T2W, the lesion invades the capsule, bladder and surrounding tissues with T1 weighted disappearance or asymmetry, with abnormal signal and muscle thickening, and pelvic lymph node metastasis with partial fusion or enlargement of lymph nodes. The MRI features of benign prostatic hyperplasia were clear boundary, complete capsule, central zone hyperplasia and uneven signal nodules. Prostatic carcinoma and prostatic hyperplasia all had varying degrees of prostate volume enlargement. Compared with the prostate hyperplasia group, the PSA, sE-cadherin and EPCA-2 levels in prostate cancer group were significantly higher. The diagnostic coincidence rate of MRI, PSA, sE-cadherin and EPCA-2 combined application in differentiating prostate cancer and prostate hyperplasia was 96.00%, which was significantly higher than 88.00%, 79%, 81% and 82% of MRI, PSA, SE-cadherin and EPCA-2 alone (P<0.05). Conclusion: MRI combined with PSA, sE-cadherin and EPCA-2 has high accuracy in the in the differential diagnosis of prostate cancer, which has the potential to be used as an guiding scheme for the early diagnosis of prostate cancer.