The aim of this study was to demonstrate the correlation between ADC values and the ADC/PSAD ratio for potentially malignant prostate lesions classified into ISUP grades and to determine threshold values to differentiate benign lesions (noPCa), clinically insignificant (nsPCa) and clinically significant prostate cancer (csPCa). We enrolled a total of 403 patients with 468 prostate lesions, of which 46 patients with 50 lesions were excluded for different reasons. Therefore, 357 patients with a total of 418 prostate lesions remained for the final evaluation. For all lesions, ADC values were measured; they demonstrated a negative correlation with ISUP grades (p< 0.001), with a significant difference between csPCa and a combined group of nsPCa and noPCa (ns-noPCa,p< 0.001). The same was true for the ADC/PSAD ratio, but only the ADC/PSAD ratio proved to be a significant discriminator between nsPCa and noPCa (p= 0.0051). Using the calculated threshold values, up to 31.6% of biopsies could have been avoided. Furthermore, the ADC/PSAD ratio, with the ability to distinguish between nsPCa and noPCa, offers possible active surveillance without prior biopsy.
本研究旨在探讨表观扩散系数（ADC）值及ADC/前列腺特异性抗原密度（ADC/PSAD）比值与按国际泌尿病理学会（ISUP）分级划分的潜在恶性前列腺病变之间的相关性，并确定区分良性病变（无前列腺癌，noPCa）、临床无意义前列腺癌（nsPCa）及临床有意义前列腺癌（csPCa）的阈值。研究共纳入403例患者的468处前列腺病灶，其中46例患者的50处病灶因不同原因被排除。最终共357例患者的418处前列腺病灶纳入最终评估。对所有病灶进行ADC值测量，结果显示ADC值与ISUP分级呈负相关（p<0.001），且csPCa与nsPCa及noPCa合并组（ns-noPCa）间存在显著差异（p<0.001）。ADC/PSAD比值呈现相同趋势，但仅该比值能显著区分nsPCa与noPCa（p=0.0051）。通过计算得出的阈值，最多可避免31.6%的穿刺活检。此外，ADC/PSAD比值具备区分nsPCa与noPCa的能力，为无需先行活检的主动监测提供了可能。
肿瘤(癌症)患者之家