Kilic Mert, Madendere Serdar, Vural Metin, Koseoglu Ersin, Balbay Mevlana Derya, Esen Tarik
Department of Urology, VKF American Hospital, Güzelbahce Street No: 20, Teşvikiye, 34365, Istanbul, Turkey.
Department of Radiology, VKF American Hospital, Istanbul, Turkey.
World J Urol. 2023 Feb;41(2):449-454. doi: 10.1007/s00345-022-04274-y. Epub 2023 Jan 3.
To evaluate the contribution of the size and number of the sampled lesions to the diagnosis of clinically significant prostate cancer (CSPC) in patients who had PI-RADS 4 lesions.
In this retrospective study, a total of 159 patients who had PI-RADS 4 lesions and underwent In-bore MRI-Guided prostate biopsy were included. Patients with a lesion classified as Grade Group 2 and above were considered to have CSPC. Univariate and multivariate regression analyses were used to evaluate the factors affecting the diagnosis of prostate cancer (PCa) and CSPC.
A great majority (86.8%) of the patients were biopsy-naïve. About three-fourths (71.7%) had PCa, and half (54.1%) had CSPC. When the patients were divided into three groups according to the index lesion size (< 5 mm, 5-10 mm, and > 10 mm), the prevalence of PCa was 64.3, 67.5, and 82.4% and the prevalence of CSPC was 42.9, 51.2, and 64.7%, respectively. In multivariate analysis, age, index lesion size, prostate volume (< 50 ml) and being biopsy-naïve were found significant for PCa, while age and prostate volume (< 50 ml) were significant for CSPC.
The number of lesions was found to be insignificant in predicting PCa and CSPC. While the size of PI-RADS 4 lesions was significant in predicting PCa, it had no significance in detecting CSPC.
评估在具有前列腺影像报告和数据系统（PI-RADS）4类病变的患者中，所取病变的大小和数量对临床显著前列腺癌（CSPC）诊断的贡献。
在这项回顾性研究中，纳入了总共159例具有PI-RADS 4类病变并接受了磁共振引导下前列腺穿刺活检的患者。病变分类为2级及以上的患者被视为患有CSPC。采用单因素和多因素回归分析来评估影响前列腺癌（PCa）和CSPC诊断的因素。
绝大多数（86.8%）患者为初次接受活检。约四分之三（71.7%）的患者患有PCa，半数（54.1%）患有CSPC。当根据索引病变大小将患者分为三组（<5毫米、5至10毫米和>10毫米）时，PCa的患病率分别为64.3%、67.5%和82.4%，CSPC的患病率分别为42.9%、51.2%和64.7%。在多因素分析中，年龄、索引病变大小、前列腺体积（<50毫升）和初次接受活检对PCa有显著影响，而年龄和前列腺体积（<50毫升）对CSPC有显著影响。
发现病变数量在预测PCa和CSPC方面无显著意义。虽然PI-RADS 4类病变的大小在预测PCa方面有显著意义，但在检测CSPC方面无显著意义。
