[系统性、靶向性及联合前列腺活检在基于MRI病灶诊断前列腺癌中的比较]

[Comparison of systematic, targeted and combined prostate biopsies for the diagnosis of prostate cancer with MRI lesion].

作者信息

Gander J, Guandalino M, Vedrine N, Charbonnel C, Gayrel P, Ceruti F, Guy L

机构信息

Service d'urologie, hôpital Gabriel-Montpied, CHU de Clermont-Ferrand, 58 rue Montalembert, 63000 Clermont-Ferrand, France.

Clinique Bon Secours, Le Puy en Velay, France.

出版信息

Prog Urol. 2022 Oct;32(12):836-842. doi: 10.1016/j.purol.2022.03.004. Epub 2022 May 13.

DOI:10.1016/j.purol.2022.03.004

PMID:35577670

Abstract

OBJECTIVE

The objective of our study is to compare the performance of systematic, targeted and combined biopsies in the same cohort for the detection of clinically significant prostate cancer (csCaP).

MATERIAL AND METHOD

We included patients coming for first series of prostate biopsies, from January 2016 to May 2020, with at least one PI-RADS lesion ≥3 on MRI. All patients underwent 12 systematic biopsies, combined with at least 2 biopsies per target lesion, using the MRI/3D ultrasound fusion system Urostation® (Koelis).

RESULTS

We included 234 patients. Combined biopsies allowed a better detection rate of csCaP (59.4%) compared to systematic biopsies (55.6%, P=0.01) and targeted biopsies alone (44.4%, P<0.001). The same is true for the overall prostate cancer (CaP) rate: 65.4% for the combined biopsies versus 61.1% for the systematic biopsies (P=0.002) and 49.1% for the targeted biopsies (P<0.001). The detection rates of clinically non-significant prostate cancer (ncsCaP) were similar (6% vs. 5.6% vs. 4.7% for combined, systematic and targeted biopsies respectively). Targeted biopsies found 10 (4.3%) CaP undiagnosed by systematic biopsies including 6 (2.6%) csCaP, and an upgraded ISUP score for 17 (7.3%) patients. Systematic biopsies found 38 (16.2%) CaP undiagnosed by targeted biopsies including 33 (14.1%) csCaP, and allowed an upgraded ISUP score for 19 (8.1%) patients.

CONCLUSION

Combined biopsies provide the best detection rate for csCaP in our study.

摘要

目的

我们研究的目的是比较在同一队列中系统活检、靶向活检及联合活检在检测临床显著前列腺癌（csCaP）方面的表现。

材料与方法

我们纳入了2016年1月至2020年5月前来进行首次前列腺活检且MRI上至少有一个PI-RADS病变≥3的患者。所有患者均接受了12次系统活检，并使用MRI/3D超声融合系统Urostation®（Koelis）对每个靶病变至少进行2次活检。

结果

我们纳入了234例患者。与系统活检（55.6%，P = 0.01）和单纯靶向活检（44.4%，P < 0.001）相比，联合活检对csCaP的检出率更高（59.4%）。总体前列腺癌（CaP）率也是如此：联合活检为65.4%，系统活检为61.1%（P = 0.002），靶向活检为49.1%（P < 0.001）。临床非显著前列腺癌（ncsCaP）的检出率相似（联合活检、系统活检和靶向活检分别为6%、5.6%和4.7%）。靶向活检发现了10例（4.3%）系统活检未诊断出的CaP，其中包括6例（2.6%）csCaP，并且有17例（7.3%）患者的ISUP评分得到提升。系统活检发现了38例（16.2%）靶向活检未诊断出的CaP，其中包括33例（14.1%）csCaP，并且有19例（8.1%）患者的ISUP评分得到提升。