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针对性活检和联合活检的比较,以避免PI-RADS 5病变患者不必要的系统活检
Changwei Yuan1, Derun Li1, Jingyun Wu2
1Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Center, No. 8 Xishiku St., Beijing 100034, China.
Biomedicines
|December 23, 2023
概括
目标活检 (TB) 在PI-RADS 5病变中有效检测前列腺癌 (PCa) 和临床显著的前列腺癌 (CSPCa),匹配较少核心的联合活检 (CB) 率. 系统活检 (SB) 提供了最小的附加值,可以省略.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 放射学 放射学是一门学科.
- 在瘤学瘤学.
背景情况:
- 多参数磁共振成像 (mpMRI) 对于定位前列腺癌 (PCa) 至关重要.
- PI-RADS 5病变代表了具有临床意义的PCa.的最高可能性.
- 准确的活检策略对于有效的PCa管理至关重要.
研究的目的:
- 用目标活检 (TB),系统活检 (SB) 和联合活检 (CB) 来比较前列腺癌 (PCa) 和临床显著前列腺癌 (CSPCa) 的检测率.
- 在PI-RADS 5病变患者中,评估结核病与SB的诊断性能.
- 为了确定PI-RADS 5病变的最佳活检策略.
主要方法:
- 从前性收集的数据库中回顾性招募585名PI-RADS 5病变患者.
- 所有患者都接受了mpMRI,其次是PI-RADS 5病变和SB的跨直肠结核病.
- 在TB,SB和CB之间比较PCa和CSPCa检测率和活检核心产量.
主要成果:
- PCa (95.73%) 和CSPCa (93.85%) 的总体检测率很高.
- 在不同瘤阶段,结核病的阳性率高 (90.56%-96.21%).
- SB为结核病增加了最小的增量检测 (1.71%PCa,1.37%CSPCa),在癌症阶段检测中没有显著差异 (p > 0.05).
- TB需要比SB更少的核心,同时实现更高的检测率 (p < 0.05).
结论:
- 目标活检 (TB) 的检测率与PI-RADS 5病变中PCa的联合活检 (CB) 的检测率相当,使用的核心较少.
- 在PI-RADS 5病变中,系统活检 (SB) 与结核病结合时提供最小的额外诊断价值.
- 在PI-RADS 5病变患者中,SB可能会被遗漏,从而简化了活检过程.
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