标题：前列腺癌患者MRI特征预测成骨性与非成骨性骨转移的价值

      作者：唐小彬，夏郁金，金雷，夏圻儿，隋海晶    上海市浦东新区人民医院，上海 201299

      卷次： 2024年35卷13期

      【摘要】 目的 探讨前列腺癌患者MRI特征在成骨性和非成骨性骨转移情况下的差异，并评估其对临床结果的预测价值。方法 回顾性分析2014年3月至2023年10月在上海市浦东新区人民医院确诊为前列腺癌并合并骨转移的63例患者的完整前列腺MRI检查及临床资料。根据CT图像的骨转移类型将其分为成骨性组(n=50)和非成骨性组(n=13)。比较两组患者的Gleason评分、前列腺特异性抗原密度(PSAD)、归一化平均表观扩散系数(nmADC)、归一化T2信号强度(nT2SI)以及前列腺影像报告和数据系统(PI-RADS)评分，采用多因素 Logistic回归分析非成骨性骨转移的相关影响因素。结果 非成骨性组患者的PSAD及nT2SI分别为[21.2 (7.6，30.4)] ng/(mL·cm3)、3.2±0.7，明显高于成骨性组的[3.5 (1.0, 29)] ng/(mL·cm3)、2.5±0.6，差异均有统计学意义(P<0.05)；非成骨性组患者的 nmADC、Gleason评分、PI-RADS评分分别为0.74 (0.68，1.1)、9 (8~9)分、5 (4~5)分，与成骨性组的0.90 (0.61，1.0)、8 (6~10)分、5 (3~5)分比较差异均无统计学意义(P>0.05)；经多变量Logistic回归分析结果显示，nT2SI是预测非成骨性骨转移的独立预测因子(优势比OR为3.22，95%可信区间为1.78~4.92)。结论 前列腺癌非成骨性骨转移患者具有较高的nT2SI和PSAD，提示具有高nT2SI和PSAD的前列腺癌患者应该接受溶骨性骨转移的相关检查。
      【关键词】 前列腺癌；磁共振成像；表观扩散系数；T2信号强度；成骨性；非成骨性；骨转移；预测价值
      【中图分类号】 R737.25 【文献标识码】 A 【文章编号】 1003—6350（2024）13—1914—05

Value of MRI features in predicting osteoblastic and non-osteoblastic bone metastases in patients with prostatecancer.
TANG Xiao-bin, XIA Yu-jin, JIN Lei, XIA Qi-er, SUI Hai-jing. Shanghai Pudong New Area People's Hospital,Shanghai 201299, CHINA
【Abstract】 Objective To investigate the differences in MRI characteristics between prostate cancer pa-tients with osteoblastic and non-osteoblastic bone metastases and to assess their predictive value for clinical out-comes. Methods A retrospective analysis was conducted on the complete prostate MRI examinations and clinical dataof 63 patients diagnosed with prostate cancer and bone metastases at Shanghai Pudong New Area People's Hospital fromMarch 2014 to October 2023. Based on CT imaging of bone metastases, patients were divided into an osteoblastic group(n=50) and a non-osteoblastic group (n=13). The Gleason scores, prostate-specific antigen density (PSAD), normalizedmean apparent diffusion coefficient (nmADC), normalized T2 signal intensity (nT2SI), and Prostate Imaging Reporting andData system (PI-RADS) scores were compared between the two groups. Multivariate logistic regression analysis was used toidentify factors associated with non-osteoblastic bone metastases. Results Patients in the non-osteoblastic group had signifi-cantly higher PSAD and nT2SI than the osteoblastic group: 21.2 (7.6, 30.4) ng/(mL·cm3) vs 3.5 (1.0, 29) ng/(mL·cm3),(3.2±0.7) vs (2.5±0.6), with statistically significant differences (P<0.05). There were no statistically significant differenc-es in nmADC, Gleason scores, or PI-RADS scores between the non-osteoblastic group [0.74 (0.68, 1.1), 9 (8-9), and 5(4-5)] and the osteoblastic group [0.90 (0.61, 1.0), 8 (6-10), and 5 (3-5)], P>0.05. Multivariate logistic regression analy-sis indicated that nT2SI was an independent predictor of non-osteoblastic bone metastases (odds ratio=3.22, 95% confi-dence interval=1.78-4.92). Conclusion Prostate cancer patients with non-osteoblastic bone metastases exhibit highernT2SI and PSAD. These findings suggest that prostate cancer patients with elevated nT2SI and PSAD should be evaluat-ed for lytic bone metastases.
      【Key words】 Prostate cancer; MRI; Apparent diffusion coefficient; T2 signal intensity; Osteoblastic; Non-osteo-blastic; Bone metastases; Predictive value