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PSA动力学在男性中扮演的角色,男性的MRI向前列腺活检呈阴性
Marcelo P Bigarella1, Arighno Das1, Diana Garcia1
1University of Wisconsin Madison, Wisconsin, USA.
对于在MRI上怀疑前列腺病变但活检结果为负的患者,大多数患者会看到PSA水平随着时间的推移正常化. 重复的MRI通常显示病变消失或退化,支持积极监测策略.
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MRI (mpMRI) 对于检测可疑的前列腺癌 (PCa) 病变至关重要.
- 负的MRI导向活检需要仔细的患者管理,以避免错过临床意义上的PCa.
研究的目的:
- 评估MRI导向前列腺活检阴性患者的复苏率和临床病理结果.
- 在mpMRI上发现可疑PI-RADS病变但非诊断性活检结果的患者的管理策略.
主要方法:
- 188名PI-RADS v2.1损伤≥3的患者在mpMRI和负MRI融合活检上进行了回顾性分析.
- 包括有针对性的和系统的核心;排除了先前癌症诊断的患者.
- 基线和随访临床病理学数据和PSA值的评估;使用Wilcoxon等级和单向测试进行统计分析.
主要成果:
- 在188名带有负面活检的患者中,6.6%在随访期间被诊断出PCa (3.8%具有临床意义).
- 在活检后的第一年和第二年,PSA水平下降.
- 在24%的患者中,重复MRI显示病变消失 (27%),降级 (48%) 或升级 (32%).
结论:
- 大多数疑似mpMRI后阴性前列腺活检的患者随着时间的推移显示PSA正常化.
- 重复的MRI发现支持最初可疑病变的良性或不那么严重的性质.
- 活跃监测是可行的策略,可疑的mpMRI后的非可疑的活检结果的患者.
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