Augustin H, Fritz G A, Ehammer T, Auprich M, Pummer K
Department of Urology, Medical University of Graz, Graz, Austria.
Acta Radiol. 2009 Jun;50(5):562-9. doi: 10.1080/02841850902889846.
An accurate prediction of final pathological stage is essential for proper patient selection to determine who will experience maximum benefit from radical prostatectomy. In this context, the Partin tables represent one of the most widely used statistical prediction tools.
To compare the accuracy in predicting pathological stage in patients intended for radical prostatectomy between 3-Tesla (T) magnetic resonance imaging (MRI) and the Partin tables in a prospective trial.
27 men with staging results from 3T MRI using a phased-array coil were compared in terms of staging accuracy with whole-mount-section histopathologic analyses as the standard of reference. Probabilities for pathological stages were estimated according to the Partin tables. Spearman rank correlation and discriminant analysis were calculated to assess relationships.
Histopathological evaluation revealed organ-confined disease (OC) in 21 (77.8%) and extracapsular extension (ECE) in six (22.2%) men. Three-Tesla MRI staging was accurate in all patients with OC and in four out of the six men with ECE. Accuracy of local staging was 85.2% (23 of 27). Sensitivity was 66.7% (95% confidence interval [CI] 0.223-0.957) and specificity 100% (95% CI 0.839-1) for the detection of ECE. Findings of MRI and the Partin tables showed a Spearman rho of 0.780 vs. 0.254 for OC and 0.780 vs. 0.363 for ECE, respectively. Compared to the Partin tables, MRI revealed standardized canonical discriminant function coefficients of 0.992 (P<0.001) vs. 0.205 (P=0.432) for OC and 0.965 (P<0.001) vs. 0.329 (P=0.197) for ECE, respectively.
3T MRI showed a high accuracy for the staging of clinically localized prostate cancer, and it was significantly more accurate in predicting the final pathological stage than the Partin tables.
准确预测最终病理分期对于正确选择患者以确定谁将从根治性前列腺切除术中获得最大益处至关重要。在此背景下，帕廷表是应用最广泛的统计预测工具之一。
在前瞻性试验中比较3特斯拉（T）磁共振成像（MRI）和帕廷表在预测拟行根治性前列腺切除术患者病理分期方面的准确性。
以全切片组织病理学分析为参考标准，比较了27例使用相控阵线圈进行3T MRI分期的男性患者在分期准确性方面的情况。根据帕廷表估算病理分期的概率。计算Spearman等级相关性和判别分析以评估相关性。
组织病理学评估显示，21例（77.8%）为器官局限性疾病（OC），6例（22.2%）为包膜外侵犯（ECE）。3T MRI分期在所有OC患者以及6例ECE患者中的4例中是准确的。局部分期的准确率为85.2%（27例中的23例）。检测ECE的敏感性为66.7%（95%置信区间[CI] 0.223 - 0.957），特异性为100%（95% CI 0.839 - 1）。MRI和帕廷表的结果显示，对于OC，Spearman相关系数分别为0.780和0.254，对于ECE分别为0.780和0.363。与帕廷表相比，MRI显示OC的标准化典型判别函数系数分别为0.992（P<0.001）和0.205（P = 0.432），ECE的分别为0.965（P<0.001）和0.329（P = 0.197）。
3T MRI对临床局限性前列腺癌的分期显示出较高的准确性，并且在预测最终病理分期方面比帕廷表显著更准确。
