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双边系统活检与向活检相结合是双边系统活检与向活检相结合的最佳替代品吗:系统性审查和元分析
Qiyou Wu1, Xiang Tu1, Jinjiang Jiang1
1Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
Urologic oncology
|December 22, 2024
概括
与向活检 (TB) 结合的ipsilateral系统活检 (ips-SB) 显示了与标准活检相比较的前列腺癌 (PCa) 和临床显著的PCa (csPCa) 检测. 这种方法可能会减少临床上无意义的PCa检测.
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.
- 医疗成像医学成像
背景情况:
- 标准前列腺活检 (SB+TB) 面临过度诊断和过度治疗的挑战.
- 研究替代活检策略对于改善前列腺癌 (PCa) 管理至关重要.
- 评估与结核病结合的ipsilateral系统活检 (ips-SB) 和 contralateral SB (con-SB) 提供了潜在的解决方案.
研究的目的:
- 为了比较ips-SB+TB和con-SB+TB与标准SB+TB的有效性.
- 评估前列腺癌 (PCa) 和临床显著PCa (csPCa) 的检测率.
- 用替代方法评估临床无意义PCa (ciPCa) 的检测.
主要方法:
- 在主要数据库 (Cochrane,Embase,Ovid,PubMed) 进行了系统的文献审查.
- 从最初的2,732个参考资料中,包括了11项相关研究.
- 分析了5,249名患者的数据,以比较活检策略的结果.
主要成果:
- Ips-SB+TB显示了与SB+TB相比的PCa (RR 0.95) 和csPCa (RR 0.98) 的检测.
- 与SB+TB相比,Con-SB+TB在csPCa检测中显示出一个统计学上显著的差异 (RR 0.92),相比SB+TB.
- 与SB+TB相比,Ips-SB+TB检测到的ciPCa病例较少 (RR 0.86),而con-SB+TB的ciPCa检测率相似 (RR 0.90).
结论:
- Ips-SB+TB提供了与标准SB+TB相比的PCa和csPCa检测效率.
- Ips-SB+TB为SB+TB提供了一个潜在的替代品,可能会减少活检核的数量.
- 该ips-SB+TB策略可能会导致临床上无意义的PCa的检测减少.
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