The value of combining transrectal ultrasound, multiparametric MRI and prostate specific antigen density in the diagnosis of prostate cancer

doi:10.3877/cma.j.issn.2095-5820.2025.03.003

Abstract

Abstract:

Objective

To investigate the value of combining transrectal ultrasound (TRUS), multiparametric magnetic resonance imaging (mpMRI), prostate specific antigen density (PSAD) in diagnosing prostate cancer (PCa) and improving the early diagnosis rate.

Methods

The clinical data of 233 patients with suspected PCa were retrospectively analyzed. Patients were stratified into 4 diagnostic groups: Group A was TRUS diagnosis group, group B was mpMRI diagnosis group, group C was PSAD diagnosis group, and group D was combined application group. The sensitivity, specificity, accuracy and Youden index were calculated and compared for each group. Kappa statistics was used to assess the consistency between the diagnostic results and pathological findings, and the area under the receiver operating characteristic curve (AUC) was compared across groups.

Results

There was no significant difference in age among the four groups (P=0.546). The sensitivity (91%), specificity (85%), accuracy (87%) and Youden index (0.76) of group D were higher than those of group A, group B and group C. The consistency between the diagnostic results of the 4 diagnostic methods and pathological results was statistically significant (all P<0.05). The Kappa value of group D was 0.729, which was higher than that of group A、B、C (Kappa=0.253、0.438、0.447). The AUC of group D was 0.880, which was better than that of group A、B、C (AUC=0.640、0.742、0.770), and the differences were statistically significant (all P<0.05).

Conclusion

The combination of TRUS, mpMRI and PSAD significantly improves the diagnostic efficiency of early PCa compared to any single modality.

Key words: prostate cancer, transrectal ultrasound, multiparametric MRI, prostate specific antigen density

Jinbing Liu, Wei Gao, Guobiao Liu, Mingkun Hu, Tiefu Xiong, Xiaofei Ding, Minling Tang, Yongyi Cai. The value of combining transrectal ultrasound, multiparametric MRI and prostate specific antigen density in the diagnosis of prostate cancer[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2025, 13(03): 143-148.

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References 37

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项目	灵敏度/%	特异度/%	准确率/%	约登指数
A组	55	73	69	0.28
B组	82	67	72	0.48
C组	81	73	75	0.54
D组	91	85	87	0.76

项目	灵敏度/%	特异度/%	准确率/%	约登指数
A组	55	73	69	0.28
B组	82	67	72	0.48
C组	81	73	75	0.54
D组	91	85	87	0.76

诊断方法	灵敏度/%	特异度/%	准确率/%	约登指数	Kappa	^aP值	AUC	^bP值
TRUS+PSAD	86	59	65	0.44	0.326	<0.001	0.722	<0.001
TRUS+mpMRI	91	52	66	0.43	0.362	0.023	0.716	0.019
PSAD+mpMRI	100	40	61	0.40	0.321	0.028	0.700	0.031
TRUS+MRI+PSAD联合	91	85	87	0.76	0.729	<0.001	0.880	<0.001

诊断方法	灵敏度/%	特异度/%	准确率/%	约登指数	Kappa	^aP值	AUC	^bP值
TRUS+PSAD	86	59	65	0.44	0.326	<0.001	0.722	<0.001
TRUS+mpMRI	91	52	66	0.43	0.362	0.023	0.716	0.019
PSAD+mpMRI	100	40	61	0.40	0.321	0.028	0.700	0.031
TRUS+MRI+PSAD联合	91	85	87	0.76	0.729	<0.001	0.880	<0.001

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