Deng Y-S, He Y-H, Ying W-W, Liu H-L, Li P-Z, Ma C-Y, Ding Z-S, Chen X, Wang J-F, Zhou X-F
Department of Urology, China-Japan Friendship Hospital, Beijing, China.
Eur Rev Med Pharmacol Sci. 2021 Mar;25(5):2221-2234. doi: 10.26355/eurrev_202103_25254.
The study aimed at investigating the value of systemic biopsy (sysPbx), magnetic resonance imaging/ultrasound fusion targeted biopsy (fusPbx) and fusPbx combined with sysPbx (comPbx) for prostate cancer (PCa) detection.
Data from the PubMed, Cochrane, and Embase databases were searched from inception until March 23, 2020. Prospective studies comparing the detection rates of sysPbx, fusPbx and comPbx were identified. We pooled the detection rates for all PCa, clinically significant prostate cancer (csPCa), and clinically insignificant prostate cancer (cinsPCa) of fusPbx, sysPbx, and comPbx. Risk ratios (RRs) were calculated for the meta-analysis. Then, analyses were performed to identify the possible sources of heterogeneity.
Seventeen studies, including 18 cohorts with 3035 men, were included. No patients had previous evidence of PCa. Each patient had one or more suspicious lesions found on multiparametric magnetic resonance imaging (mpMRI) and received both fusPbx and sysPbx. The results showed that fusPbx and sysPbx did not differ significantly in detecting all PCa (RR=1.00, 95% CI: 0.95-1.05, p>0.05). However, fusPbx provided a higher detection rate for csPCa (RR=1.24, 95% CI: 1.14-1.34, p<0.05) and a lower detection rate for cinsPCa (RR=0.68, 95% CI: 0.61-0.76, p<0.05) than sysPbx. In addition, comPbx detected more PCa (RR=1.22, 95% CI: 1.16-1.29, p<0.05) and csPCa cases (RR=1.13, 95% CI: 1.05-1.21, p<0.05) than fusPbx.
In men with positive mpMRI findings, compared to sysPbx, fusPbx had significantly increased the detection rates for csPCa and decreased those for cinsPCa. The combination of fusPbx with sysPbx outperformed fusPbx in detecting both overall PCa and csPCa.
本研究旨在探讨系统活检（sysPbx）、磁共振成像/超声融合靶向活检（fusPbx）以及fusPbx联合sysPbx（comPbx）在前列腺癌（PCa）检测中的价值。
检索PubMed、Cochrane和Embase数据库自创建至2020年3月23日的数据。纳入比较sysPbx、fusPbx和comPbx检测率的前瞻性研究。我们汇总了fusPbx、sysPbx和comPbx对所有PCa、临床显著前列腺癌（csPCa）和临床非显著前列腺癌（cinsPCa）的检测率。计算风险比（RRs）用于荟萃分析。然后，进行分析以确定异质性的可能来源。
纳入17项研究，包括18个队列共3035名男性。所有患者既往均无PCa证据。每位患者在多参数磁共振成像（mpMRI）上发现一个或多个可疑病灶，并接受了fusPbx和sysPbx。结果显示，fusPbx和sysPbx在检测所有PCa方面无显著差异（RR = 1.00，95% CI：0.95 - 1.05，p>0.05）。然而，与sysPbx相比，fusPbx对csPCa的检测率更高（RR = 1.24，95% CI：1.14 - 1.34，p<0.05），对cinsPCa的检测率更低（RR = 0.68，95% CI：0.61 - 0.76，p<0.05）。此外，comPbx在检测PCa（RR = 1.22，95% CI：1.16 - 1.29，p<0.05）和csPCa病例（RR = 1.13，95% CI：1.05 - 1.21，p<0.05）方面比fusPbx检测到的更多。
在mpMRI结果为阳性的男性中，与sysPbx相比，fusPbx显著提高了csPCa的检测率，降低了cinsPCa的检测率。fusPbx与sysPbx联合在检测总体PCa和csPCa方面均优于fusPbx。
