Sun Fei, Lucas-Cava Vanesa, Sánchez-Margallo Francisco Miguel
Jesus Uson Minimally Invasive Surgery Centre, Caceres, Spain.
Transl Androl Urol. 2020 Aug;9(4):1754-1768. doi: 10.21037/tau-20-437.
Prostatic artery embolization (PAE) has been established as a routine treatment for symptomatic benign prostatic hyperplasia (BPH) all over the world. With increasing clinical experience in the last decade, investigators have sufficient data to assess predictive factors with the purpose to guide patient selection and counseling for PAE or to individualize therapeutic plans after PAE. This paper is a comprehensive review to introduce the concept of clinical predictors and give a systemic classification of various predictive factors in PAE. The authors review each individual factor and its predictive capability and discuss the possible reasons for the inconsistent or conflicting findings in the literature. Based on current evidence, the baseline prostate volume, in particular the transition zone volume and transition zone index; 24 h post-PAE prostate-specific antigen (PSA) level; and prostate infarction and prostate volume reduction at 1-3 months have potential in prediction of treatment outcomes. Patients with Adenomatous-dominant BPH or with indwelling bladder catheter before PAE may have more benefits from PAE. Baseline intravesical prostatic protrusion (IPP), C-reactive protein (CRP) level at 48 h and early detection of prostate infarct at 1 day and 1 week after PAE need further investigating.
前列腺动脉栓塞术（PAE）已成为全球有症状良性前列腺增生（BPH）的常规治疗方法。在过去十年中，随着临床经验的增加，研究人员有足够的数据来评估预测因素，以指导PAE的患者选择和咨询，或使PAE后的治疗计划个体化。本文是一篇全面综述，旨在介绍临床预测因素的概念，并对PAE中各种预测因素进行系统分类。作者回顾了每个单独因素及其预测能力，并讨论了文献中结果不一致或相互矛盾的可能原因。基于目前的证据，基线前列腺体积，特别是移行区体积和移行区指数；PAE后24小时前列腺特异性抗原（PSA）水平；以及1-3个月时的前列腺梗死和前列腺体积缩小，对预测治疗结果具有潜力。腺瘤性为主的BPH患者或PAE前留置膀胱导管的患者可能从PAE中获益更多。基线膀胱内前列腺突出（IPP）、48小时时的C反应蛋白（CRP）水平以及PAE后1天和1周时前列腺梗死的早期检测需要进一步研究。
