Norris Joseph M, Carmona Echeverria Lina M, Simpson Benjamin S, Ball Rhys, Freeman Alex, Kelly Daniel, Kirkham Alex, Whitaker Hayley C, Emberton Mark
UCL Division of Surgery and Interventional Science, University College London, London, UK
UCL Division of Surgery and Interventional Science, University College London, London, UK.
BMJ Open. 2020 Oct 22;10(10):e039735. doi: 10.1136/bmjopen-2020-039735.
Multiparametric MRI (mpMRI) has improved risk stratification for men with suspected prostate cancer. Indeed, mpMRI-visible tumours tend to be larger and of higher pathological grade than mpMRI-invisible tumours; however, concern remains around significant cancer that is undetected by mpMRI. There has been considerable recent interest to investigate whether tumour conspicuity on mpMRI is associated with additional histopathological features (including cellular density, microvessel density and unusual prostate cancer subtypes), which may have important clinical implications in both diagnosis and prognosis. Furthermore, analysis of these features may help reveal the radiobiology that underpins the actual mechanisms of mpMRI visibility (and invisibility) of prostate tumours. Here, we describe a protocol for a systematic review of the histopathological basis of prostate cancer conspicuity on mpMRI.
A systematic search of the MEDLINE, PubMed, Embase and Cochrane databases will be conducted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines will be used to guide screening, thematic reporting and conclusions drawn from all eligible studies. Included papers will be full-text, English-language articles, comparing the histopathological characteristics of mpMRI-visible lesions and mpMRI-invisible tumours. All studies published between January 1950 and January 2020 will be eligible for inclusion. Studies using confirmatory immunohistochemistry for the identification of immune subsets or structural components will be included. Study bias and quality will be assessed using a modified Newcastle-Ottawa scale. To ensure methodological rigour, this protocol is written in accordance with the PRISMA Protocol 2015 checklist. If appropriate, a meta-analysis will be conducted comparing histopathological feature frequency between mpMRI-visible and mpMRI-invisible disease.
No ethical approval will be required as this is an academic review of published literature. Findings will be disseminated through publications in peer-reviewed journals and presentations at national and international conferences.
CRD42020176049.
多参数磁共振成像（mpMRI）改善了对疑似前列腺癌男性的风险分层。的确，mpMRI可见的肿瘤往往比mpMRI不可见的肿瘤更大且病理分级更高；然而，对于mpMRI未检测到的显著癌症仍存在担忧。最近，人们对研究mpMRI上肿瘤的显见度是否与其他组织病理学特征（包括细胞密度、微血管密度和不寻常的前列腺癌亚型）相关产生了浓厚兴趣，这可能在诊断和预后方面具有重要的临床意义。此外，对这些特征的分析可能有助于揭示作为前列腺肿瘤mpMRI可见性（和不可见性）实际机制基础的放射生物学。在此，我们描述了一项对mpMRI上前列腺癌显见度的组织病理学基础进行系统评价的方案。
将对MEDLINE、PubMed、Embase和Cochrane数据库进行系统检索。系统评价和Meta分析的首选报告项目（PRISMA）指南将用于指导筛选、主题报告以及从所有符合条件的研究中得出结论。纳入的论文将是全文、英文文章，比较mpMRI可见病变和mpMRI不可见肿瘤的组织病理学特征。1950年1月至2020年1月期间发表的所有研究均符合纳入条件。使用确证性免疫组织化学鉴定免疫亚群或结构成分的研究将被纳入。将使用改良的纽卡斯尔-渥太华量表评估研究偏倚和质量。为确保方法的严谨性，本方案按照PRISMA方案2015清单编写。如果合适，将进行Meta分析，比较mpMRI可见和mpMRI不可见疾病之间组织病理学特征的频率。
由于这是对已发表文献的学术综述，无需伦理批准。研究结果将通过在同行评审期刊上发表以及在国内和国际会议上报告来传播。
PROSPERO注册号：CRD42020176049。
