扩展核心采样与延迟干预和积极监测患者的病理结果的关联 一个基于人口的分析
Rashid K Sayyid1, Rui Bernardino1, Zizo Al-Daqqaq2
1Division of Urology, Department of Surgical Oncology, University of Toronto, Princess Margaret Cancer Centre, Toronto, ON, Canada.
概括
扩展前列腺癌活检采样减少了停止积极监测和经历病理升级的可能性. 这种方法改善了积极监测患者的风险分层.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 病理学 病理学 病理学
背景情况:
- 综合系统和向活检改善了临床上显著的前列腺癌检测.
- 积极监测 (AS) 是低风险前列腺癌的管理策略.
- 优化初始活检策略对于有效的AS管理至关重要.
研究的目的:
- 评估在初始活检时扩展核心采样是否会影响AS停止治疗.
- 评估扩展核心采样和AS患者随后的病理结果之间的关联.
- 确定最佳的活检策略,以对有资格接受主动监测的风险分层患者进行活检.
主要方法:
- 从SEER数据库分析国家综合癌症网络 (NCCN) 的低风险和有利的中期风险 (FIR) AS患者 (2010-2015年).
- 活检采样分为标准 (10-12核),扩展 (13-20核) 或超扩展 (21+核) 的类别.
- 多变量后勤回归用于分析结果,包括延迟的最终干预和病理升级/降级.
主要成果:
- 扩展核心采样降低了低风险和GG2FIR患者的最终干预几率.
- 超扩展采样降低了PSA 10-20 FIR患者的最终干预几率.
- 超扩展采样降低了升级到低风险患者的≥GG2和GG2FIR患者的≥GG3的几率.
结论:
- 扩展和超扩展的活检采样与较低的AS断药率有关.
- 在诊断时增加核心采样改善了AS患者的病理风险分层.
- 扩展组织采样对于最大限度地减少AS停止治疗和确保准确的患者管理至关重要.
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