GIÁ TRỊ CỦA KHÁNG NGUYÊN ĐẶC HIỆU TUYẾN TIỀN LIỆT VÀ CỘNG HƯỞNG TỪ ĐA THAM SỐ TRONG CHẨN ĐOÁN UNG THƯ TUYẾN TIỀN LIỆT

Abstract

Objectives: To evaluate the diagnostic value of total prostate-specific antigen (tPSA), prostate-specific antigen density (PSAd), and multiparametric magnetic resonance imaging (mpMRI) using the PI-RADS classification in the detection of prostate cancer (PCa). Methods: A cross-sectional descriptive study with analysis was conducted on 92 patients with suspected PCa who underwent prostate biopsy at Da Nang Oncology Hospital from April 2024 to September 2025. All patients underwent serum tPSA testing, PSAd calculation, and prostate mpMRI (3.0 Tesla), interpreted according to PI-RADS version 2.1. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curves, area under the curve (AUC), sensitivity, and specificity. Results: The biopsy-proven PCa rate was 47.8%. The risk of prostate cancer increased significantly in patients with higher PI-RADS categories and elevated PSA levels. PI-RADS demonstrated the highest diagnostic performance with an AUC of 0.932, outperforming tPSA (AUC = 0.879) and PSAd (AUC = 0.869). At the optimal cut-off value, PI-RADS achieved a sensitivity of 93.2% and a specificity of 91.7%, while both tPSA and PSAd showed sensitivity and specificity of ≥ 84%. Conclusion: mpMRI using the PI-RADS classification provides the highest diagnostic accuracy and effective risk stratification for prostate cancer. tPSA and PSAd remain useful tools for screening and initial assessment.