在确定临床上显著的前列腺癌时,前列腺特异性抗原密度的准确性是否会随前列腺体积而变化?
Leonardo Quarta1, Francesco Pellegrino1, Armando Stabile1
1Unit of Urology/Division of Oncology, Gianfranco Soldera Prostate Cancer Laboratory, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
European urology focus
|December 24, 2025
概括
前列腺特异性抗原密度 (PSAD) 临床显著前列腺癌 (csPCa) 的风险因前列腺大小而异. 在PI-RADS 3病变和更大的前列腺 (>40毫升) 的男性中,PSAD对于cSPCa检测更有价值.
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.
- 放射学 放射学是一门学科.
背景情况:
- 前列腺特异性抗原密度 (PSAD) 通过多参数MRI (mpMRI) 提高前列腺癌 (PCa) 诊断.
- 前列腺体积对各种PSAD水平的csPCa风险的影响在具有阳性mpMRI发现 (PI-RADS≥3) 的患者中仍然不清楚.
研究的目的:
- 为了研究临床显著前列腺癌 (csPCa) 的风险如何随着不同 PSAD 值的前列腺体积而变化.
- 为了确定PSAD在csPCa检测中的实用性,基于PI-RADS≥3.3的患者的前列腺大小的变化.
主要方法:
- 对1731名具有阳性mpMRI发现 (PI-RADS ≥3) 的患者进行了回顾性分析,这些患者接受了MRI向加上系统活检.
- 基于PSAD和前列腺体积的csPCa风险分层.
- 绘图预测了csPCa风险作为PSAD的函数,以评估前列腺体积的PSAD截止值变化.
主要成果:
- 在56%的患者中诊断出cspca.
- 对于0.10 ng/ml/ml的PSAD,中位数预测的csPCa风险是前列腺<45毫升的37%,前列腺60-100毫升的15%.
- 在PI-RADS 3病变中,不论前列腺的PSAD<40毫升,csPCa风险都超过10%. 对于前列腺>40毫升,10%的csPCa风险的PSAD截止值在0.10至0.15 ng/ml/ml之间.
结论:
- 对于csPCa检测PSAD的预测性能受到前列腺体积的显著影响.
- 在前列腺体体积>40毫升时,PSAD在患有PI-RADS 3病变的男性中检测csPCa具有更大的附加值.
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