二次性损伤活检在检测临床显著前列腺癌中的作用

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Trevor C Hunt¹, Zijing Cheng^1,2, Ashley Li¹

¹Department of Urology, University of Rochester Medical Center, Rochester, New York, USA.

|February 24, 2025

概括

在前列腺癌检测中的二次病变 (SLs) 活检在进行系统活检 (SB) 和索引病变 (IL) 向活检 (TB) 时,不会显著改善临床显著的前列腺癌 (csPCa) 检测率. 省略SL活检可以减少患者的不适和成本,而不会影响结果.

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) 和聚变向活检 (TB) 提高了临床显著前列腺癌 (csPCa) 的检测.
指南建议在mpMRI上对所有可疑病变进行活检,但对二次病变 (SL) 的证据有限.
除了索引损伤 (IL) 和系统活检 (SB) 之外,SL活检的附加价值需要进一步的研究来检测csPCa.

研究的目的:

评估在接受前列腺活检的患者mpMRI上发现的活检SL的额外诊断价值.
为了确定SL活检是否会提高csPCa检测率,与单独的IL活检相比,当SB也被执行时.
评估PSA密度和SLPI-RADS得分对csPCa检测的影响.

主要方法:

对73名患有多个PI-RADS≥3病变的男性进行了前列腺活检的回顾性分析.
在SB+IL结核病与SB+IL结核病+SL结核病之间的csPCa检测率的比较.
二次分析检查了PSA密度和SLPI-RADS得分;灵敏度分析证实了强度.

主要成果:

单独使用SB和IL结核病的csPCa检测率为47%,添加SL活检后增加到52% (p=0.62).
根据PSA密度或SLPI-RADS得分,没有观察到csPCa检测的显著差异.
在三项敏感性分析中,有两项支持了主要发现,表明了结果的稳定性.

结论:

当SB和IL TB进行时,切除SLs不会显著增加csPCa检测率.
省略SL活检可能是一个安全的策略,可能减少患者的不适和程序成本.
这些发现可能会为前列腺癌活检指南的未来更新提供信息.

关键词:

这就是为什么MRI是MRI.在PSA密度上,PSA密度是:多焦点性是多焦点性的.瘤学在瘤学方面.查检查查检查查检查查检查泌尿病学泌尿病学泌尿病学

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