摘要
目的:多参数磁共振成像(multiparametric magnetic resonance imaging, mpMRI)联合血清碱性磷酸酶(alkaline phosphatase, ALP)、D-二聚体(D-dimer, DD2)、纤维蛋白原(fibrinogen, FIB)诊断前列腺癌骨转移的效能分析。方法:对169例前列腺癌患者的临床资料进行回顾性收集和分析,根据骨扫描的检查结果辅以核磁共振,将盆腔有无骨转移的病人分为前列腺癌骨转移组80例和非骨转移组89例。所有患者在手术前都接受了MRI检查,对血清PSA、ALP、D-二聚体、FIB水平进行定量检测。对不同影像指标与前列腺癌骨转移结果之间的一致性采用Kappa一致性检验;利用单因素和多因素Logistic回归分析,评估mpMRI、ALP、D-二聚体、FIB及其他临床指标在前列腺癌骨转移诊断中的价值。利用受试者工作特征(receiver operating characteristic, ROC)曲线对前列腺癌骨转移中纳入的mpMRI、ALP、D-二聚体、FIB及其联合指标的临床应用价值进行评价。结果:T1WI、T2WI压脂、DWI及mpMRI与前列腺癌骨转移结果比较的Kappa值分别为0.536、0.470、0.629、0.691 (P Objective: To analyze the efficacy of multiparametric MRI (mpMRI) combined with serum ALP, D-dimer, and FIB in the diagnosis of bone metastasis in prostate cancer. Methods: A retrospective collection and analysis of clinical data from 169 prostate cancer patients were conducted. Based on the results of bone scans supplemented by MRI, patients with or without pelvic bone metastasis were divided into the prostate cancer bone metastasis group (80 cases) and the non-bone metastasis group (89 cases). All patients underwent MRI examination prior to surgery, and serum levels of PSA, ALP, D-dimer, and FIB were quantitatively measured. Kappa consistency tests were used to analyze the agreement between different imaging indicators and the results of prostate cancer bone metastasis. Uni- and multivariable logistic regression analyses were performed to evaluate the value of mpMRI, ALP, D-dimer, FIB, and other clinical indicators in the diagnosis of prostate cancer bone metastasis. The clinical application value of mpMRI, ALP, D-dimer, FIB, and their combined indicators in diagnosing prostate cancer bone metastasis was assessed using receiver operating characteristic (ROC) curves. Results: The Kappa values comparing T1WI, T2WI fat suppression, DWI, and mpMRI with the results of prostate cancer bone metastasis were 0.536, 0.470, 0.629, and 0.691, respectively (P < 0.001). Compared to the non-bone metastasis group, the serum levels of ALP, D-dimer, and FIB in the bone metastasis group were significantly higher (P < 0.001). Multivariable logistic regression analysis indicated that mpMRI, ALP, D-dimer, and FIB are independent risk factors for prostate cancer bone metastasis (P < 0.05). The combined indicators showed the best performance, followed by the individual indicators of D-dimer, mpMRI, ALP, and FIB, all of which demonstrated good diagnostic value (P < 0.05). Conclusion: mpMRI, ALP, D-dimer, and FIB all demonstrate certain diagnostic efficacy for prostate cancer bone metastasis. The combined use of these indicators can further enhance diagnostic value, suggesting that they should be considered for broader application in clinical practice.
出处
《临床医学进展》
2025年第2期900-907,共8页
Advances in Clinical Medicine
