Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, 264000, Shandong, P. R. China.
Department of Urology, First Affiliated Hospital, Sun Yat-Sen University, No.58 ZhongShan 2nd Road, Guangzhou, 510080, Guangdong, P. R. China.
BMC Urol. 2020 Jul 16;20(1):100. doi: 10.1186/s12894-020-00659-6.
To investigate the value of using contrast-enhanced transrectal ultrasound (CETRUS) to reduce unnecessary collection of biopsies during prostate cancer diagnosis and its utility in predicting biochemical recurrence in patients with localized prostate cancer.
This was a prospective study of suspected prostate cancer patients who were evaluated with CETRUS followed by a prostate biopsy. Prostate blood flow via CETRUS was graded using a 5-point scale. The relationship between CETRUS score and biopsy outcome was then analyzed for all patients; univariate and multi-variate analyses were used to determine the probable prognostic factors for biochemical recurrence in patients with localized prostate cancer that underwent a radical prostatectomy.
A total of 347 patients were enrolled in the study. Prostate cancer was found in 164 patients. A significant positive correlation (r = 0.69, p < 0.001) was found between CETRUS scores and prostate cancer incidence. Using CETRUS scores ≥2 as the threshold for when to biopsy could have safely reduced the number of biopsies taken overall by 12.1% (42/347) and spared 23.0% (42/183) of patients from undergoing an unnecessary biopsy. 77 patients with localized prostate cancer underwent a radical prostatectomy. The median follow-up time was 30 months (range: 8-56 months) and 17 of these 77 patients exhibited biochemical recurrence during the follow-up period. 3-year biochemical recurrence-free survival rates were 86% for patients with low CETRUS scores (≤ 3) and 59% for patients with high scores (> 3; p = 0.015). Multivariate Cox regression analysis indicated that CETRUS score was an independent predictor of biochemical recurrence (HR: 7.02; 95% CI: 2.00-24.69; p = 0.002).
CETRUS scores may be a useful tool for reducing the collection unnecessary biopsy samples during prostate cancer diagnosis and are predictive of biochemical recurrence in patients with localized prostate cancer following a radical prostatectomy.
研究使用对比增强经直肠超声（CETRUS）减少前列腺癌诊断中不必要的活检采集的价值及其在预测局限性前列腺癌患者生化复发中的作用。
这是一项对疑似前列腺癌患者进行 CETRUS 评估后行前列腺活检的前瞻性研究。通过 CETRUS 评估前列腺血流，使用 5 分制进行评分。然后分析所有患者的 CETRUS 评分与活检结果之间的关系；使用单变量和多变量分析确定接受根治性前列腺切除术的局限性前列腺癌患者生化复发的可能预测因素。
共有 347 例患者入组研究。164 例患者发现前列腺癌。CETRUS 评分与前列腺癌发生率之间存在显著正相关（r=0.69，p<0.001）。将 CETRUS 评分≥2 作为活检阈值，可以安全地减少 347 例患者总体活检次数 12.1%（42/347），避免 23.0%（42/183）的患者接受不必要的活检。77 例局限性前列腺癌患者接受了根治性前列腺切除术。中位随访时间为 30 个月（范围：8-56 个月），77 例患者中有 17 例在随访期间出现生化复发。低 CETRUS 评分（≤3）患者的 3 年生化无复发生存率为 86%，高评分（>3）患者为 59%（p=0.015）。多变量 Cox 回归分析表明，CETRUS 评分是生化复发的独立预测因子（HR：7.02；95%CI：2.00-24.69；p=0.002）。
CETRUS 评分可作为减少前列腺癌诊断中不必要活检样本采集的有用工具，并可预测接受根治性前列腺切除术的局限性前列腺癌患者的生化复发。
