Renard-Penna Raphaële, Roupret Morgan, Compérat Eva, Rozet François, Granger Benjamin, Barkatz Johann, Bitker Marc Olivier, Lucidarme Olivier, Cussenot Olivier, Mozer Pierre
Academic Department of Radiology, AP-HP, Hopital Pitié-Salpétrière, 83 Bvd Hôpital, 75013, Paris, France.
GRC5, ONCOTYPE-Uro, Institut Universitaire de Cancérologie, UPMC Univ Paris 06, 75005, Paris, France.
World J Urol. 2016 May;34(5):673-8. doi: 10.1007/s00345-015-1685-2. Epub 2015 Sep 24.
To assess whether non-suspicious multiparametric magnetic-resonance imaging (mpMRI) was associated with no cancer or indolent prostate cancer (PCa) in subsequent biopsies.
Retrospective analyses of a prospective database were conducted between 2009 and 2013. It included men with an abnormal digital rectal examination and/or prostate-specific antigen levels <20 ng/mL and a non-suspicious multiparametric MRI (Likert score <3). Participants underwent a systematic 12-extended-core biopsy ultrasound protocol (STD). Indolent PCa was defined as a single core with a Gleason score of 6 (3 + 3) and a cancer-core length of ≤4 mm.
Seventy-eight patients with a negative MRI were included in the study; median patient age was 62 years (IQR 50-74). Median PSA level was 7.15 ng/mL, with a median PSA density of 0.15. The digital rectal examination was abnormal in eight cases. From MRI, 53 patients were Likert 2, 25 patients were Likert 1, and median prostate volume was 56.5 mL. From biopsies, no cancer was found in 92.3 % (n = 72). PCa was histologically confirmed in six patients (7.7 %): five cases were indolent (as defined above); only one patient had a cancer core of 5 mm long, with a Gleason score of 6 (3 + 3). All six patients were within the low-risk group according to the D'Amico classification.
Men with non-suspicious mpMRI are likely to have no or indolent PCa in subsequent biopsies.
评估非可疑多参数磁共振成像（mpMRI）与后续活检中无癌症或惰性前列腺癌（PCa）是否相关。
对2009年至2013年的前瞻性数据库进行回顾性分析。纳入直肠指检异常和/或前列腺特异性抗原水平<20 ng/mL且多参数MRI非可疑（李克特评分<3）的男性。参与者接受了系统性12针扩展穿刺活检超声方案（STD）。惰性PCa定义为单个穿刺针芯的Gleason评分为6（3+3）且癌芯长度≤4 mm。
78例MRI阴性的患者纳入研究；患者中位年龄为62岁（四分位间距50-74岁）。中位PSA水平为7.15 ng/mL，中位PSA密度为0.15。8例直肠指检异常。MRI检查中，53例患者李克特评分为2，25例患者李克特评分为1，中位前列腺体积为56.5 mL。活检结果显示，92.3%（n=72）未发现癌症。6例患者（占7.7%）经组织学确诊为PCa：5例为惰性PCa（如上定义）；仅1例患者癌芯长度为5 mm，Gleason评分为6（3+3）。根据达米科分类，所有6例患者均属于低风险组。
多参数MRI非可疑的男性在后续活检中可能无PCa或患有惰性PCa。
