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PIRADS≥4MRI损伤:执行系统活检是否仍然是检测临床显著前列腺癌的必要条件?
Fayek Taha1, Benjamin Branchu2, Natacha Demichel1
1CHU de Reims, 1, rue du General-Koenig, 51100 Reims, France.
系统活检仍然对于检测临床显著的前列腺癌 (csPCa) 是必不可少的,因为单独的向活检在12.3%的PIRADS 4或5病变病例中错过了csPCa. 进一步的分析没有确定错过csPCa的预测因素.
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.
- 放射学 放射学是一门学科.
背景情况:
- 随着MRI向前列腺活检的兴起,系统活检的作用受到争议.
- 临床显著的前列腺癌 (csPCa) 被定义为ISUP等级2或更高.
研究的目的:
- 在MRI显示PIRADS 4或5病变时,确定仅在系统核心上诊断的csPCa率.
- 为了确定 csPCa 的预测因子,通过向活检错过了.
主要方法:
- 对358名接受MRI/横直肠美国融合活检的患者 (2015-2021) 的回顾性分析.
- 纳入标准:至少有一个PIRADS 4或5目标病变.
- 所有程序包括1-4个目标核心和12个系统核心.
主要成果:
- 在12.3%的患者中,csPCa仅在系统核心中检测到.
- 其中,有27.2%的人在向活检时没有癌症,9.09%的人在指数损伤的同一侧缺乏csPCa.
- PSA,PSA密度,前列腺体积,DRE和MRI特征无法预测目标活检中遗漏的csPCa.
结论:
- 单独针对性活检在12.3%的病例中不足以检测cspca.
- 系统活检在前列腺癌的当前诊断途径中仍然至关重要.
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