基线前列腺MRIPI-RADS分类与活跃监测期间格里森升级风险之间的关联:系统性审查和元分析
Shayan Smani1, Nishan Sohoni1, Marcin Miszczyk2,3
1Yale School of Medicine, New Haven, CT, USA.
World journal of urology
|February 15, 2026
概括
前列腺MRIPI-RADS得分预测在积极监测 (AS) 的有利风险前列腺癌 (PCa) 患者的格里森等级组 (GG) 升级风险. 较高的PI-RADS分数 (4-5) 表示GG升级的风险更大.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 放射学 放射学是指放射学
- 在瘤学瘤学.
背景情况:
- 前列腺磁共振成像 (MRI) 有助于检测高度前列腺癌 (PCa).
- 基线MRI前列腺成像报告和数据系统 (PI-RADS) 对积极监测 (AS) 管理的有利风险PCa的得分的预测价值仍然不清楚.
研究的目的:
- 调查基线PI-RADS得分与格里森等级组 (GG) 升级风险之间的关联,在接受AS的具有有利风险的PCa患者中.
主要方法:
- 在八个数据库中进行了系统的文献搜索,以确定相关的研究.
- 使用Hartung-Knapp随机效应模型进行了危险比率 (HR) 的元分析.
- 使用ROBINS-I工具评估了偏差风险.
主要成果:
- 包括11项包括6309名患者的研究;注意到中度偏差风险.
- 与PI-RADS 1-3病变相比,基线PI-RADS 4-5病变与GG升级的风险显著增加有关 (HR: 2.21).
- 与PI-RADS 1-2相比,PI-RADS 3,4 和 5 的病变逐渐显示出更高的升级风险.
结论:
- 基线前列腺MRIPI-RADS得分对AS的有利风险PCa患者的GG升级具有高度预后.
- 研究结果表明,基于初步MRI结果,有可能开发定制的监测策略.
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