mri检测结外延伸作为前列腺癌侵袭性的标志。

IF 4.7 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
European Radiology Pub Date : 2025-10-01 Epub Date: 2025-04-05 DOI:10.1007/s00330-025-11532-1
Aline Araújo Naves, Gabriel de Lion Gouvea, Camila V B Machado, Leandro Machado Colli, Fernando Chahud, Rodolfo B Reis, Valdair F Muglia
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引用次数: 0

摘要

目的:结外延伸(ENE)是多种癌症侵袭性的组织学标志。我们评估了通过磁共振成像检测到的临床ENE是否也可以作为前列腺癌(PCa)侵袭性的生物学标志物。材料和方法:本回顾性单中心研究分析了2013年1月至2017年12月诊断为PCa并在3-T扫描仪上进行MRI检查的患者。排除后,纳入461例患者,分为:1组,无淋巴结累及(LNI), 2组(无ENE的LNI)和3组(LNI和ENE)。两名经验丰富的放射科医生评估了MRI扫描的原发性病变特征,LNI和ENE。计算ENE和PI-RADS的重现性评价。分析临床结果,包括总生存期(OS)、特定生存率(SSR)和无进展生存期(PFS)。结果:1组410例,2组32例,3组19例。ENE的患病率为4.1%。各组之间在年龄、PSA、dPSA、ISUP评分、临床风险分层和分期方面存在显著差异(均为p)。结论:尽管mri检测到的ENE患病率较低,但它是PCa中SSR和PFS的预测指标。这些发现支持ENE作为一个独立的预后指标。需要进一步的前瞻性、多机构研究来验证这些结果。病理结外延伸(pENE)已被描述为前列腺癌(PCa)预后令人担忧的标志,但临床ENE尚未被评估为前列腺癌预后的标志。mri检测到的临床ENE在我们的队列中患病率较低(4.1%),但它是特定生存率和无进展生存率的预测因子。mri检测到的临床ENE是一种可重复的成像特征,可以作为侵袭性前列腺癌的非侵入性生物标志物。它与较差的无进展生存率和特定生存率相关,为患者管理提供了有价值的预后见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
MRI-detected extranodal extension as a marker of prostate cancer aggressiveness.

Objective: Extranodal extension (ENE) is a histological marker of aggressiveness for various cancers. We evaluated if clinical ENE, detected by Magnetic Resonance Imaging, can also serve as a biological marker of Prostate Cancer (PCa) aggressiveness.

Materials and methods: This retrospective, single-center study analyzed patients diagnosed with PCa and had MRI on a 3-T scanner from January 2013 to December 2017. After exclusions, 461 patients were included and divided into: Group 1, no lymph node involvement (LNI), Group 2 (LNI without ENE), and Group 3 (LNI and ENE). Two experienced radiologists assessed the MRI scans for primary lesion characteristics, LNI and ENE. Reproducibility assessment was calculated for ENE and PI-RADS. Clinical outcomes, including Overall Survival (OS), Specific Survival Rate (SSR), and Progression-Free Survival (PFS), were analyzed.

Results: Group 1 included 410 patients, Group 2, 32 patients, and Group 3, 19 patients. The prevalence of ENE was 4.1%. Significant differences between groups were observed for age, PSA, dPSA, ISUP scores, clinical risk stratification, and staging (all p < 0.01). The Kappa coefficient for ENE was 0.75 (95% CI: 0.56-0.90), and 0.48 (0.14-1.0) for PI-RADS. Cox proportional hazards model showed PSA (HR: 1.009; 95% CI = 1.003-1.015, p < 0.01) and ENE (HR: 8.50; 1.76-40.98, p < 0.01) were associated with SSR, and both ENE (HR: 8.18; 2.34-28.58, p < 0.01) and LNI (HR: 5.99, 1.97-18.17, p < 0.01) were linked to poor PFS.

Conclusion: MRI-detected ENE, despite low prevalence, is a predictor of SSR and PFS in PCa. These findings support ENE as an independent prognostic marker. Further prospective, multi-institutional studies are required to validate these results.

Key points: Question Pathological extranodal extension (pENE) has been described as a marker of worrisome prognosis in prostate cancer (PCa), but clinical ENE has not been evaluated as a marker of prognosis in PCa. Findings MRI-detected clinical ENE, had a low prevalence in our cohort (4.1%), but it was a predictor of specific survival rate and progression-free survival. Clinical relevance MRI-detected clinical ENE, a reproducible imaging feature, may serve as a non-invasive biomarker for aggressive prostate cancer. It correlates with poorer progression-free survival and specific survival rates, offering valuable prognostic insights for patient management.

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来源期刊
European Radiology
European Radiology 医学-核医学
CiteScore
11.60
自引率
8.50%
发文量
874
审稿时长
2-4 weeks
期刊介绍: European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.
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