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山东大学学报 (医学版) ›› 2021, Vol. 59 ›› Issue (4): 108-113.doi: 10.6040/j.issn.1671-7554.0.2020.1670

• 临床医学 • 上一篇    下一篇

多参数磁共振与经直肠超声融合前列腺靶向穿刺活检在检测PI-RADS≥3前列腺癌中的临床价值

孙鼎琪,傅强,张辉,刘帅,刁统祥,曹庆伟,张克勤   

  1. 山东第一医科大学附属省立医院泌尿外科, 山东 济南 250021
  • 发布日期:2021-04-30
  • 通讯作者: 张克勤. E-mail:kqzhang81@aliyun.com
  • 基金资助:
    山东省重点研发计划(2018GSF118142);山东省自然科学基金(ZR2017BH036);山东省医药卫生科技发展计划(2017WS289)

Clinical value of targeted multiparameter MRI and transrectal ultrasonography fusion prostate biopsy for the detection of PI-RADS≥3 prostate cancer

SUN Dingqi, FU Qiang, ZHANG Hui, LIU Shuai, DIAO Tongxiang, CAO Qingwei, ZHANG Keqin   

  1. Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
  • Published:2021-04-30

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摘要： 目的 评价多参数磁共振(mpMRI)与经直肠超声(TRUS)融合前列腺靶向穿刺活检在检测前列腺癌(PCa)和临床显著性前列腺癌(csPCa)的临床价值。 方法 收集2018年9月至2020年6月161例前列腺影像和数据报告系统评分(PI-RADS)≥3的患者资料纳入本研究。随机分为两组,前列腺系统穿刺患者80例(系统穿刺组)和mpMRI/TRUS融合前列腺靶向穿刺活检+前列腺系统穿刺活检患者81例(联合穿刺组)。对活检的临床资料和病理结果进行分析。 结果 联合穿刺组mpMRI/TRUS融合前列腺靶向穿刺活检的PCa检出率高于前列腺系统穿刺活检,但差异无统计学意义(χ2=0.627,P=0.429)。联合穿刺组PCa检出率高于系统穿刺组(χ2=3.880,P=0.049)。联合穿刺组中有40例被诊断为csPCa,系统穿刺组中有22例被诊断为csPCa,联合穿刺组csPCa检出率高于系统穿刺组(χ2=8.139,P=0.004)。在Gleason评分≤6分时,联合穿刺组中mpMRI/TRUS融合前列腺靶向穿刺活检的检出率明显低于系统前列腺穿刺(P=0.029)。Gleason评分>6分时,mpMRI/TRUS融合前列腺靶向穿刺活检的检出率均高于前列腺系统穿刺(P=0.010)。 结论 在PI-RADS≥3的患者中,mpMRI/TRUS融合前列腺靶向穿刺活检在PCa和csPCa的检出率上优于系统前列腺活检,但仍遗漏了部分前列腺癌患者,包括csPCa。将mpMRI/TRUS融合前列腺靶向穿刺活检和系统前列腺穿刺活检相结合,可以更好地检测所有前列腺癌,特别是csPCa。

关键词: 前列腺癌, 靶向穿刺, 多参数磁共振, 超声融合, 前列腺影像和数据报告系统

Abstract: Objective To evaluate the clinical value of multiparameter magnetic resonance imaging(mpMRI)and transrectal ultrasonography(TRUS)fusion prostate biopsy for the detection of prostate cancer(PCa)and clinical significant prostate cancer(csPCa). Methods A total of 161 patients treated during Sep. 2018 and Jun. 2020 with prostate imaging reporting and data system(PI-RADS)≥3 were enrolled in this study. The patients were randomly assigned to undergo either systematic prostate biopsy(systematic group)or targeted mpMRI/TRUS fusion prostate biopsy + systematic prostate biopsy(combined group). The clinical data and pathological results of biopsies were analyzed. Results The detection rate of PCa by targeted mpMRI/TRUS fusion prostate biopsy was higher than that of systematic prostate biopsy, but there was no significantly difference(χ2=0.627,P=0.429). There were 40 cases in the combined group and 22 in the systematic group diagnosed as csPCa, respectively. The detection rate of csPCa was much higher in the combined group(χ2=8.139, P=0.004). When Gleason score>6, targeted mpMRI/TRUS fusion prostate biopsy had significantly higher detection rate than systematic biopsy(P=0.010). Conclusion In patients with PI-RADS≥3 prostate cancer, targeted mpMRI/TRUS fusion prostate biopsy has higher detection rates of PCa and csPCa than systematic prostate biopsy, but it still misses some cases. Combination of targeted mpMRI/TRUS fusion prostate biopsy and systematic prostate biopsy can improve the detection rate of all prostate cancers, especially csPCa.

Key words: Prostate cancer, Targeted biopsy, Multiparameter magnetic resonance imaging, Transrectal ultrasonography fusion, Prostate imaging reporting and data system

中图分类号: 

  • R737.25
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