在系统活检的基础上进行靶向活检可提高前列腺癌筛查的癌症检出率。

IF 1.1 Q4 ONCOLOGY
International journal of clinical and experimental pathology Pub Date : 2024-05-15 eCollection Date: 2024-01-01 DOI:10.62347/JHYY2053
Peizi Li, Pu Ni, Faruk Erdem Kombak, Emily Wolters, George Kenneth Haines, Qiusheng Si
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引用次数: 0

摘要

背景:在过去几年中,磁共振成像(MRI)/超声靶向活检经常与12核系统活检一起用于前列腺癌筛查。然而,与系统性活检相比,靶向活检的疗效及其与临床病理学的相关性仅在有限的几项研究中进行了评估,本研究对此进行了进一步调查:我们收集了从2019年4月至2022年4月进行靶向和系统性前列腺活检的960个病例(表1)。我们比较了不同级别组的靶向和系统性前列腺活检的癌症检出率。我们还分析了每种活检方法与前列腺病变大小、前列腺特异性抗原(PSA)水平以及前列腺影像报告和数据系统(PI-RADS)评分的相关性:在接受靶向活检和系统活检的 960 名男性中,有 652 例(67.9%)确诊为前列腺腺癌。489例(50.9%)通过靶向活检确诊,576例(60.0%)通过系统活检确诊。在系统活检诊断为阴性的 384 例病例中,靶向活检发现了 76 例(8%)癌症。系统活检能够发现 163 例目标活检漏检的癌症病例。与靶向活检相比,系统活检发现了更多的 1 级癌症。然而,对于等级较高的癌症,靶向活检与系统活检的癌症检出率差异变得微不足道。在一些病例中,靶向活检提高了系统活检的等级组别(1、2、3、4 和 5 级分别为 3.8%、7.0%、2.6%、1.1% 和 0.9%)。靶向活检更有可能在较大的病灶(13.17 毫米 VS 11.41 毫米,P=0.0056)和较高的 PI-RADS 分级(4.19 VS 3.68,PC结论:与单独进行系统活检相比,靶向活检结合系统活检提高了癌症检出率。靶向活检对 1、4 或 5 级癌症的敏感度并不高,但在检测 2 级和 3 级癌症方面,其敏感度与系统活检相同。当患者的病灶较大、PI-RADS评分较高和PSA水平较高时,靶向活检能更有效地检测出癌症。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Targeted biopsy added to systematic biopsy improves cancer detection in prostate cancer screening.

Background: Magnetic resonance imaging (MRI)/ultrasound targeted biopsy has frequently been used together with a 12-core systematic biopsy for prostate cancer screening in the past few years. However, the efficacy of targeted biopsy compared to systematic biopsy, as well as its clinical-histologic correlation, has been assessed by a limited number of studies and is further investigated in this study.

Design: We collected 960 cases with both targeted and systematic prostate biopsies from 04/2019 to 04/2022 (Table 1). We compared cancer detection rates between targeted and systematic prostate biopsies in different grade groups. Correlations with the size of prostate lesions, prostate-specific antigen (PSA) level, and Prostate Imaging-Reporting and Data System (PI-RADS) scale were also analyzed for each of these biopsy methods.

Results: Among the 960 men who underwent targeted biopsy with systematic biopsy, prostatic adenocarcinoma was diagnosed in 652 (67.9%) cases. 489 (50.9%) cases were diagnosed by targeted biopsy and 576 (60.0%) cases were diagnosed by systematic biopsy. In the 384 cases diagnosed negative by systematic biopsy, targeted biopsy identified cancer in 76 (8%) cases. Systematic biopsy was able to detect 163 cancer cases that were missed by targeted biopsy. Systematic biopsy detected more grade group 1 cancers compared to targeted biopsy. However, for higher grade cancers, the differences between the cancer detection rates of targeted biopsy and systematic biopsy became negligible. Targeted biopsy upgraded the grade group categorized by systematic biopsy in several cases (3.8%, 7.0%, 2.6%, 1.1% and 0.9% in Grade Groups 1, 2, 3, 4, and 5 respectively). Targeted biopsy was more likely to detect cancer in larger lesions (13.17 mm VS 11.41 mm, P=0.0056) and for higher PI-RADS scales (4.19 VS 3.68, P<0.0001). The cancers detected by targeted biopsy also had higher PSA levels (10.38 ng/ml VS 6.39 ng/ml, P=0.0026).

Conclusion: Targeted biopsy with systematic biopsy improved cancer detection rate compared to systematic biopsy alone. Targeted biopsy is not more sensitive for grade groups 1, 4, or 5 cancers but is as sensitive as systematic biopsy for detecting grade group 2 and 3 cancers. Targeted biopsy is more effective at detecting cancers when patients have larger lesions, higher PI-RADS scales, and higher PSA levels.

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来源期刊
自引率
0.00%
发文量
42
审稿时长
1 months
期刊介绍: The International Journal of Clinical and Experimental Pathology (IJCEP, ISSN 1936-2625) is a peer reviewed, open access online journal. It was founded in 2008 by an international group of academic pathologists and scientists who are devoted to the scientific exploration of human disease and the rapid dissemination of original data. Unlike most other open access online journals, IJCEP will keep all the traditional features of paper print that we are all familiar with, such as continuous volume and issue numbers, as well as continuous page numbers to keep our warm feelings towards an academic journal. Unlike most other open access online journals, IJCEP will keep all the traditional features of paper print that we are all familiar with, such as continuous volume and issue numbers, as well as continuous page numbers to keep our warm feelings towards an academic journal.
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