对前列腺癌查方案的有效性进行比较:欧洲泌尿病学协会和欧洲随机查前列腺癌战略研究
Zhenwei Yang1,2, Luuk A van Duuren3, Monique J Roobol4
1Department of Biostatistics, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
International journal of cancer
|February 25, 2026
概括
欧洲泌尿病学会 (EAU) 的前列腺癌 (PC) 查协议通过减少过度诊断和活检来优化效率. 这种风险适应的方法,使用前列腺特异性抗原 (PSA) 测试,风险计算器 (RC) 和磁共振成像 (MRI),保持低PC死亡率.
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.
- 医疗模拟 医疗模拟
背景情况:
- 前列腺癌 (PC) 查降低了死亡率,但导致过度诊断和不必要的活检.
- 欧洲泌尿病学协会 (EAU) 提出了一项风险调整的查方案,但其长期结果尚未定量.
研究的目的:
- 量化EAU风险调整PC查协议的长期结果.
- 用微模拟模型将EAU协议与其他查策略进行比较.
主要方法:
- 开发了MIcrosimulation SCreening Analysis-PSA模型,以模拟个人前列腺特异性抗原 (PSA) 轨迹.
- 使用欧洲前列腺癌查随机研究 (ERSPC) 数据对模型进行校准.
- 模拟了55-69岁男性的五种查方案,包括固定间隔,PSA间隔,MRI导向活检,MRI风险计算器 (RC) 和完整的EAU协议.
主要成果:
- 与ERSPC协议相比,基于PSA的间隔将PSA测试减少了21%.
- 仅使用MRI的方案使过度诊断减少了6%,但MRI利用率增加了.
- 与仅使用MRI相比,整合RC可减少10%的过度诊断和36%的MRI使用.
结论:
- 该协议有效地平衡了PC死亡率,过度诊断和资源利用.
- 这种适应风险的方法优化了查效率,显著减少了活检和过度诊断.
- 整合MRI和RC增强了PC查中的资源配置.
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