Knight Andrew S, Sharma Pranav, de Riese Werner T W
Department of Urology, School of Medicine, Texas Tech University Health Sciences Center, 3601-4th Street STOP 7260, Lubbock, TX, 79430-7260, USA.
Int Urol Nephrol. 2022 Dec;54(12):3047-3054. doi: 10.1007/s11255-022-03351-w. Epub 2022 Aug 30.
Magnetic resonance imaging (MRI) is a precise, systemic and advantageous imaging technique when compared to transrectal ultrasound (TRUS) which is very operator dependent. The negative correlation between prostate volume and the incidence of prostate cancer (PCa) obtained by TRUS biopsy has been well documented in the literature. The purpose of this systemic review is analyzing the reported MRI-fusion study results on prostate biopsies regarding any correlation between prostate volume and the incidence of PCa.
After defining the inclusion and exclusion criteria an in-depth review were performed between 01.01.2000 and 02.08.2022 using the PubMed database and applying the "PRISMA" guidelines.
Twelve studies qualified, and all showed an inverse/negative relationship between prostate volume and incidence of PCa. Sample sizes ranged from 33 to 2767 patients in single and multi-institutional studies. All studies showed a statistically significant inverse relationship with a p value < 0.05. The graph summarizing all of studies and using Fisher's method revealed a highly significant combined p level of 0.00001. Additionally, not one single study was found showing the contrary (a positive correlation between prostate size and the incidence of PCa).
To our knowledge, this is the first systemic review of reported MRI-Fusion data on the incidence of PCa in correlation with prostate volume. This MRI review confirms previous TRUS-biopsy studies which demonstrated an inverse relationship between prostate volume and the incidence of PCa, and thus further supports the hypothesis that large prostates size may be protective against PCa when compared to smaller prostates.
与非常依赖操作者的经直肠超声(TRUS)相比,磁共振成像(MRI)是一种精确、系统且具有优势的成像技术。TRUS活检得出的前列腺体积与前列腺癌(PCa)发病率之间的负相关在文献中已有充分记载。本系统评价的目的是分析已报道的关于前列腺活检的MRI融合研究结果,以探讨前列腺体积与PCa发病率之间的相关性。
在确定纳入和排除标准后,于2000年1月1日至2022年8月2日期间使用PubMed数据库并遵循“PRISMA”指南进行了深入评价。
12项研究符合条件,所有研究均显示前列腺体积与PCa发病率之间呈反比/负相关。单机构和多机构研究中的样本量从33例至2767例患者不等。所有研究均显示具有统计学意义的反比关系,p值<0.05。汇总所有研究并采用Fisher方法绘制的图表显示合并p值高度显著,为0.00001。此外,未发现有任何一项研究显示相反结果(前列腺大小与PCa发病率之间呈正相关)。
据我们所知,这是首次对已报道的关于PCa发病率与前列腺体积相关性的MRI融合数据进行系统评价。这项MRI评价证实了先前TRUS活检研究的结果,即前列腺体积与PCa发病率之间呈反比关系,从而进一步支持了以下假说:与较小前列腺相比,较大前列腺体积可能对PCa具有保护作用。