基于MRI的积极监测队列中前列腺癌生长率的变化
Hayley Smith1, Vasilis Stavrinides2,3,4, Francesco Giganti5,6
1Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. hs898@cam.ac.uk.
European radiology
|January 16, 2026
概括
前列腺癌生长缓慢,个体差异很大. 病变平均需要17年才能被MRI检测到,这对早期检测策略构成了挑战.
科学领域:
- 在瘤学瘤学.
- 医疗成像医学成像
- 生物统计学 生物统计学
背景情况:
- 优化查和主动监测 (AS) 时间表需要了解前列腺癌瘤生长率.
- 瘤生长的个体变化需要个性化的估计方法.
研究的目的:
- 在纵向主动监测队列中估计前列腺癌生长率.
- 模拟前列腺癌病变的自然史,从单细胞到临床检测.
主要方法:
- 长度建模145名活检确认的前列腺癌患者的瘤生长,这些患者接受了基于MRI的AS.
- 通过平面测量测量损伤体积变化的指数,戈珀茨和后勤混合效应模型的比较.
- 调查生长速度与临床特征 (如年龄,PSA水平和格里森得分) 之间的相关性.
主要成果:
- 戈珀茨模型有效地估计了从单细胞的瘤生长到MRI可检测的大小 (约. 3毫米直径).
- 增长速度与患者年龄,初始病变体积,PSA水平和PSA密度正相关.
- 格里森3+4病变的体积翻倍时间 (3.5年) 比格里森3+3病变 (5.2年) 更快.
- 从单细胞到MRI检测尺寸的平均时间为17年;到临床检测尺寸是额外的12年.
- 在50岁时,75%的病变仍然无法通过MRI检测到.
结论:
- 前列腺癌呈现缓慢增长的现象,患者之间的差异很大,使早期检测工作复杂化.
- 缓慢的生长轨迹和检测惰性病变的潜力对积极监测协议构成挑战.
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