Department of Urology, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Department of Urology, Municipal Hospital, 400139 Cluj-Napoca, Romania.
Medicina (Kaunas). 2021 May 22;57(6):519. doi: 10.3390/medicina57060519.
Systematic prostate biopsy (SB) has a low Gleason group (GG) accuracy when compared to final pathology. This may negatively impact the inclusion of patients into specific risk groups and treatment choice. The aim of our study was to assess the GG accuracy of magnetic resonance imaging-ultrasound (MRI-US) fusion prostate biopsy. Of a cohort of minimally invasive radical prostatectomy (RP), we selected all patients who were diagnosed with prostate cancer (PCa) via MRI-US fusion biopsy ( = 115). Combined biopsy had the highest rate for GG concordance (61.7% vs. 60.4% for SB vs. 45.3% for MRI-US fusion biopsy) and the lowest for upgrading (20.9% vs. 24.5% for SB vs. 34.9% for MRI-US fusion biopsy), < 0.0001. No clinical data were predictive for upgrading or downgrading at final pathology. Locally advanced PCa was associated with a high Prostate Imaging-Reporting and Data System (PIRADS) score ( = 0.0014) and higher percentages of positive biopsy cores (PBC)/targeted ( = 0.0002) and PBC/total ( = 0.01). Positive surgical margins were correlated with higher percentages of PBC/systematic ( = 0.003) and PBC/total ( = 0.009). Pre-biopsy prostate MRI improves GG concordance between biopsy and RP. Combined biopsy provides the highest grading accuracy when compared to final pathology. Targeted and systematic biopsy data are predictive for adverse pathologic outcomes.
系统前列腺活检（SB）与最终病理相比，格里森分组（GG）准确性较低。这可能会对患者纳入特定风险组和治疗选择产生负面影响。我们研究的目的是评估磁共振成像-超声（MRI-US）融合前列腺活检的 GG 准确性。在一组微创根治性前列腺切除术（RP）中，我们选择了所有通过 MRI-US 融合活检诊断为前列腺癌（PCa）的患者（= 115 例）。联合活检 GG 一致性最高（61.7%比 SB 的 60.4%，MRI-US 融合活检的 45.3%），升级率最低（20.9%比 SB 的 24.5%，MRI-US 融合活检的 34.9%），<0.0001。最终病理无预测升级或降级的临床数据。局部晚期 PCa 与高前列腺成像报告和数据系统（PIRADS）评分（= 0.0014）和更高比例的阳性活检核心（PBC）/靶向（= 0.0002）和 PBC/总（= 0.01）相关。阳性切缘与更高比例的 PBC/系统（= 0.003）和 PBC/总（= 0.009）相关。术前前列腺 MRI 提高了活检与 RP 之间 GG 的一致性。与最终病理相比，联合活检提供了最高的分级准确性。靶向和系统活检数据可预测不良病理结果。
