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目的应用判别分析探讨不同指标对前列腺癌预测诊断中的应用价值。方法收集2008年1月-2011年9月经直肠超声检查并行经直肠超声引导下经会阴前列腺穿刺活检术,具有前列腺特异性抗原(PSA)、超声图像特征的941例患者以及其中含有血流阻力指数(RI)指标的200例患者的临床资料,采用最近距离及极大似然判别分析两种方法分别拟合患者年龄、血清PSA、经直肠前列腺超声声像图特征以及RI指标预测前列腺癌。结果最近距离判别分析显示RI对前列腺癌的判别无临床意义。联合患者年龄、超声检查和血清PSA值,判别结果提示超声、超声+年龄、年龄+超声+PSA三种判别的灵敏度逐渐增加。年龄+超声+PSA联合指标的灵敏度为88.89%,其错判率在20.00%以内。结论年龄+超声+PSA联合指标的极大似然判别分析可提高前列腺癌的诊断预测水平,避免前列腺穿刺给患者带来的痛苦,并给临床医生的临床诊断提供参考,有较好的应用价值。
Objective To investigate the application value of different indexes in predictive diagnosis of prostate cancer by discriminant analysis. Methods A total of 941 patients with prostate-specific antigen (PSA) and ultrasonographic features under transrectal ultrasound-guided transrectal ultrasound guided transrectal ultrasonography were enrolled in this study from January 2008 to September 2011. They included blood flow resistance index (RI) index of 200 patients with clinical data, the use of the nearest distance and maximum likelihood discriminant analysis of two methods were fitted to patients age, serum PSA, transrectal ultrasound sonography features and RI indicators predict prostate cancer. Results The recent distance discriminant analysis showed that RI was not clinically significant in discriminating prostate cancer. Combined with the age of patients, ultrasound and serum PSA values, the results suggest that ultrasound, ultrasound + age, age + ultrasound + PSA three discrimination sensitivity gradually increased. The combined sensitivity of age + ultrasound + PSA was 88.89%, and the miscarriage rate was within 20.00%. Conclusion The maximum likelihood discriminant analysis of age combined with ultrasound + PSA can improve the predictive value of prostate cancer and avoid the pain caused by prostate biopsy, and provide a reference for clinical diagnosis of clinicians, which has a good application value .