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在MRI检测的格里森等级组 (GG) 2和系统活检检测的GG1前列腺癌中,复发风险相比较
Abderrahim-Oussama Batouche1,2,3, Eugen Czeizler1,3, Timo-Pekka Lehto1,3
1Research Program in Systems Oncology, Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
BJU international
|December 15, 2025
概括
通过向活检诊断出格里森等级组 (GG) 2 前列腺癌的男性在治疗后的复发风险与通过系统活检诊断出GG1癌症患者相似. 然而,GG2患者更有可能接受治愈治疗.
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.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 前列腺癌 (PCa) 诊断已经通过MRI向活检进化.
- 格里森等级组 (GG) 分类对PCa的攻击性进行了分层.
- 区分真正的疾病进展和诊断重新分类至关重要.
研究的目的:
- 为了比较最终治疗的可能性和治疗后复发的风险.
- 为了评估通过向活检诊断的GG2 PCa患者与通过系统活检诊断的GG1 PCa患者.
主要方法:
- 使用大型三级中心注册表进行回顾性研究.
- 包括3317名GG1PCa患者 (系统活检) 和554名GG2PCa患者 (向活检) 从1993年至2019年.
- 卡普兰-梅尔曲线和考克斯回归分析了无治疗和无复发的生存率.
主要成果:
- 针对性活检检测到的GG2 PCa患者的治疗时间 (4个月) 比系统性活检测到的GG1 PCa (31个月) 显著缩短.
- 治愈后治疗复发的风险在各组之间相似 (HR1.04,95% CI 0.75-1.43).
结论:
- 通过MRI向活检诊断的GG2 PCa与系统活检的GG1 PCa相比,治疗后出现类似的复发风险.
- 在GG2中较高的治疗率可能反映了重新分类,不一定是更具侵略性的疾病.
- 加强风险分层是需要在MRI时代GG2PCa患者的积极监测.
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