系统活检在靶向活检时代的作用:综述

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS
Wojciech Malewski, Tomasz Milecki, Omar Tayara, Sławomir Poletajew, Piotr Kryst, Andrzej Tokarczyk, Łukasz Nyk
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引用次数: 0

摘要

前列腺癌(PCa)是一个重大的公共卫生问题,它是第二大常见癌症,也是导致男性癌症相关死亡的第五大原因。许多 PCa 病例并不严重,风险极低,因此积极监控是一种合适的管理方法。然而,有临床意义的前列腺癌(csPCa)会导致严重的健康问题,包括恶化、转移和死亡。区分无临床意义的前列腺癌(inPCa)和有临床意义的前列腺癌(csPCa)对于确定适当的治疗方法至关重要。前列腺癌的诊断主要包括经会阴和经直肠的系统性活检。系统性经直肠前列腺活检通常要收集 10-12 份组织样本,是一种标准方法,但它可能会漏诊 csPCa,并伴有一些并发症。磁共振成像(MRI)靶向活检等最新进展被认为可以改善风险分层,减少对inPCa的过度治疗和对csPCa的治疗不足,从而提高患者的生活质量和治疗效果。引导下活检能够更好地检测出高风险癌症,同时减少低风险病例的识别,因此越来越多地受到推荐。磁共振成像靶向活检,尤其是作为活检无效患者和积极监测患者的初始活检时,已变得越来越普遍。单独使用 MRI-TB 可以减少化脓性并发症;但建议将靶向活检与周围取样相结合,以优化 csPCa 的检测。未来成像和活检技术的进步,包括人工智能增强病灶检测和机器人辅助取样,有望进一步提高 PCa 检测的准确性和有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Role of Systematic Biopsy in the Era of Targeted Biopsy: A Review
Prostate cancer (PCa) is a major public health issue, as the second most common cancer and the fifth leading cause of cancer-related deaths among men. Many PCa cases are indolent and pose minimal risk, making active surveillance a suitable management approach. However, clinically significant prostate carcinoma (csPCa) can lead to serious health issues, including progression, metastasis, and death. Differentiating between insignificant prostate cancer (inPCa) and csPCa is crucial for determining appropriate treatment. Diagnosis of PCa primarily involves trans-perineal and transrectal systematic biopsies. Systematic transrectal prostate biopsy, which typically collects 10–12 tissue samples, is a standard method, but it can miss csPCa and is associated with some complications. Recent advancements, such as magnetic resonance imaging (MRI)-targeted biopsies, have been suggested to improve risk stratification and reduce overtreatment of inPCa and undertreatment of csPCa, thereby enhancing patient quality of life and treatment outcomes. Guided biopsies are increasingly recommended for their ability to better detect high-risk cancers while reducing identification of low-risk cases. MRI-targeted biopsies, especially when used as an initial biopsy in biopsy-naïve patients and those under active surveillance, have become more common. Utilization of MRI-TB alone can decrease septic complications; however, the combining of targeted biopsies with perilesional sampling is recommended for optimal detection of csPCa. Future advancements in imaging and biopsy techniques, including AI-augmented lesion detection and robotic-assisted sampling, promise to further improve the accuracy and effectiveness of PCa detection.
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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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