前立腺被膜外浸潤に関する骨盤MRIの診断成績及び血清PSA値の有用性について

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前立腺被膜外浸潤所見と術前の骨盤MRI及び血清PSAとの関係を検討した.術前の骨盤MRIでの前立腺癌被膜外浸潤の正診率は63.3%と低かった.一方,術前血清PSA値のcut off値を17ng/mlとした場合,被膜外浸潤の正診率は89.7%であり,病期判定の評価基準の一つとして有用であると思われたTransrectal ultrasonography (TRUS), computed tomography (CT), and magnetic resonance imaging (MRI) are employed to diagnose the clinical stage of prostate cancer. However, several cases are diagnosed as pathological stage pT3 after total prostatectomy. We investigated the accuracy of the evaluation of pathologic capsular penetration by preoperative pelvic MRI and preoperative serum PSA level and capsular penetration. The diagnostic accuracy of capsular penetration by MRI was 63.3%. On the other hand, the diagnostic accuracy of capsular penetration by preoperative PSA was 89.7% when its cut off value was 17 ng/ml. We conclude that preoperative serum PSA level could be more useful to diagnose accurately stage of prostate cancer than pelvic MRI.