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除了有针对性的活检外,区域性与系统性活检:系统性审查和元分析的结果
Francesco Sanguedolce1, Carol Nelly Gianna Lauwers2, Alessandro Tedde2
1Fundació Puigvert, Department of Urology, Uro-Oncology Unit, Barcelona, Spain; Institut Reserca Sant Pau, Barcelona, Spain; Dipartimento di Medicina, Chirurgia e Farmacia, Universitá degli Studi di Sassari, Sassari, Italy.
European urology oncology
|October 25, 2024
概括
有针对性的活检 (TBx) 加上区域活检 (RBx) 可以有效地检测出临床显著的前列腺癌 (csPCa),而无需磁共振成像 (MRI) 可见的病变. 这种方法可以消除在早期检测途径中需要系统活检 (SBx) 的需要.
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.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 磁共振成像 (MRI) 改善了前列腺病变的可视化.
- 针对MRI可见病变周围的向活检 (TBx),结合区域活检 (RBx),正在被探索为传统系统活检 (SBx) 的替代方案.
研究的目的:
- 将TBx + RBx与TBx + SBx的参考标准之间的临床显著前列腺癌 (csPCa) 检测产量进行比较.
- 评估在csPCa.诊断途径中省略SBx的疗效.
主要方法:
- 在PubMed,Embase和Web of Science进行了系统的文献搜索,直到2023年9月.
- 对21项遵循PRISMA指南的研究进行了元分析,评估了csPCa的检测收益率 (ISUP等级组≥2).
- 使用 QUADAS-2 标准进行包含研究的质量评估.
主要成果:
- 在TBx + RBx (44.2%) 和TBx + SBx (46.1%) (OR1.07,p=0.07) 之间的csPCa检测收益率没有统计学上显著的差异.
- 高度前列腺癌的类似检测率 (ISUP等级组≥3).
- TBx + SBx显示了较低级癌症的更高检测率 (ISUP等级组1).
结论:
- TBx + RBx 策略是检测csPCa的一个可行的选择,在MRI上可见病变时可能取代SBx.
- 这种方法可能有助于减少惰前列腺癌的检测,同时保持对侵略性瘤的检测.
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