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阴性前列腺活检的危险因素:CHAID决策树分析
Pierre Allainguillaume1, Coralie Uthe-Spencker1, Laura Larnaudie2
1Urology Department Cochin Hospital, APHP Paris France.
前列腺癌风险是由PSA密度和PIRADS得分预测的. 大的前列腺体积增加了低PIRADS得分的男性的负面活检的风险,需要仔细的MRI解释.
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:
- 前列腺癌 (PCa) 诊断严重依赖前列腺活检.
- 对临床显著的前列腺癌 (csPCa) 的准确风险分层对于患者管理至关重要.
研究的目的:
- 在接受前列腺活检的当代队列中分析任何前列腺癌 (PCa) 和临床显著前列腺癌 (csPCa) 的风险.
- 确定PCa和csPCa检测的独立预测因素.
主要方法:
- 对接受前列腺活检的255名患者 (2020年12月至2022年12月) 的回顾性分析.
- 计算PCa和csPCa率 (ISUP等级≥2) 的方法.
- 使用单变量和多变量回归,以及CHAID决策树分析.
主要成果:
- 69.8%的患者的活检结果为PCa,为csPCa为36.9%.
- PSA 密度 (PSAd) 和 PIRADS 评分是 csPCa 的独立预测指标.
- 对于任何PCa检测,PIRADS得分≤4和前列腺体积>46mL的患者,负面活检的风险翻了一番.
结论:
- PSA 密度和 PIRADS 评分是 csPCa 的关键预测指标.
- 大的前列腺体积是PIRADS ≤4的患者负面活检的重要预测因素,不论PSAd.
- 在MRI解释和针对PIRADS ≤4和前列腺大小的患者时,建议谨慎.
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