活检格莱森等级1组前列腺癌患者的死亡风险
Derya Tilki1, Ming-Hui Chen2, Hartwig Huland3
1Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Koc University Hospital, Istanbul, Turkey.
European urology oncology
|July 3, 2024
概括
高前列腺特异性抗原 (PSA) 水平或在格里森等级1组前列腺癌患者中50%以上的阳性活检表明患有侵袭性疾病和死亡率的风险更高. 考虑对这个子组进行再活检,以确定可能未采样的高等级癌症.
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:
- 通过系统活检 (SBx) 或联合活检 (CBx) 诊断的格里森等级1组 (GGG1) 前列腺癌 (PC) 可能存在未采样的高风险疾病.
- 呈现时的临床因素对于在进行激进前列腺切除术后识别潜在的PC不足阶段的患者至关重要.
研究的目的:
- 调查在呈现时临床因素与未采样高风险PC的存在之间的关联.
- 评估这些因素与GGG1PC患者的急性前列腺切除术后的PC特定死亡率 (PCSM) 和全因死亡率 (ACM) 之间的关系.
主要方法:
- 一项由10228名在德国大学医院接受GGG1PC治疗的患者进行的队列研究.
- 后勤,精细和灰色和考克斯回归模型被用于分析与不良病理,早期PSA失败,PCSM和ACM的关联.
主要成果:
- 百分比阳性活检 (PPB) >50%和PSA>20 ng/ml显著与不良病理和早期PSA失败的风险更高有关,无论活检方法如何.
- 在SBx组中,PPB>50%和PSA>20 ng/ml也与PCSM和ACM的风险增加有关 (p ≤0.04).
- 大约12个GGG1PC患者中的1个在活检上可能会比最初检测到的更具侵略性的癌症.
结论:
- 患有GGG1PC和PPB>50%或PSA>20 ng/ml的患者代表风险增加的亚组.
- 保持"癌症"分类,并考虑对这些患者进行再活检,可能有助于识别未采样的高等级疾病,并减轻死亡风险.
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