Correlation of multimodal MRI parameters and PSA with Gleason grading in patients with prostate cancer and their predictive efficacy for Gleason grading and prognosis
10.3760/cma.j.cn115355-20240803-00378
- VernacularTitle:多模态MRI参数联合PSA与前列腺癌患者Gleason分级的相关性及其对Gleason分级和预后的预测效能
- Author:
Lei YI
1
;
Jiayuan SUN
1
;
Qin LI
1
Author Information
1. 如皋市人民医院放射科，南通 226500
- Publication Type:Journal Article
- Keywords:
Prostate neoplasms;
Magnetic resonance imaging;
Prostate-specific antigen;
Gleason grading;
Prognosis
- From:
Cancer Research and Clinic
2025;37(9):661-666
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the correlation between multimodal magnetic resonance imaging (MRI) parameters combined with prostate-specific antigen (PSA) and Gleason grading in prostate cancer patients, as well as their predictive efficacy for Gleason grading and overall survival (OS).Methods:A retrospective case series study was conducted. The clinical data of 103 prostate cancer patients who were admitted to Rugao People's Hospital from July 2019 to June 2023 were retrospectively analyzed. All patients underwent multimodal MRI scanning, serum PSA and free PSA (fPSA) testing; biopsy or surgical specimens were taken and stained with hematoxylin eosin (HE) to make slices, and Gleason grading was performed on patients. The multimodal MRI parameters [apparent diffusion coefficient (ADC), volume transfer constant (Ktrans), interstitium-plasma rate constant (Kep), extracellular vascular space volume fraction (Ve)] and serum PSA and fPSA levels of patients with different Gleason grades were compared, and the correlations between multimodal MRI parameters, serum PSA levels and Gleason grading were analyzed using Pearson method; Kaplan-Meier method was used to plot the OS curve; receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of multimodal MRI parameters combined with PSA level for Gleason grading and OS of patients.Results:Among the 103 patients, there were 23 patients with well differentiated cancer, 52 patients with moderately differentiated cancer, and 28 patients with poorly differentiated cancer. The comparison of ADC, Ktrans, Kep, PSA level, and fPSA level among the three groups of patients showed statistically significant differences (all P < 0.05); the comparison of Ve showed no statistically significant difference ( P > 0.05). ADC was negatively correlated with Gleason grading ( r = -0.619, P < 0.001), while Ktrans, Kep and PSA level were positively correlated with Gleason grading ( r values were 0.773, 0.828 and 0.906, respectively, all P < 0.001); there was no correlation between Ve and Gleason grading ( r = 0.093, P = 0.352). The ROC curve showed that the AUC of ADC, Ktrans and Kep combined with PSA level for predicting Gleason grading of patients was 0.999, and the AUC for predicting OS was 0.966, both of which were higher than the single indicators (all P < 0.05). The patients were followed-up until June 2024, there were 63 survivors, 35 deaths, and 5 lost to follow-up among 103 patients, with a median OS time of 55.0 months (95% CI: 53.7-56.2 months). Conclusions:There is a correlation between multimodal MRI parameters, PSA and Gleason grading in prostate cancer patients. The combination of multimodal MRI parameters and PSA has good predictive effects on Gleason grading and OS.
