Chang Chun-Bi, Lin Yu-Chun, Wong Yon-Cheong, Lin Shin-Nan, Lin Chien-Yuan, Lin Yu-Han, Sheng Ting-Wen, Yang Lan-Yan, Wang Li-Jen
Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Gueishan, Taoyuan 33305, Taiwan.
Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan 33302, Taiwan.
Life (Basel). 2023 Sep 21;13(9):1944. doi: 10.3390/life13091944.
The International Society of Urological Pathology (ISUP) grade and positive surgical margins (PSMs) after radical prostatectomy (RP) may reflect the prognosis of prostate cancer (PCa) patients. This study aimed to investigate whether DCE-MRI parameters (i.e., , , and IAUC) could predict ISUP grade and PSMs after RP.
Forty-five PCa patients underwent preoperative DCE-MRI. The clinical characteristics and DCE-MRI parameters of the 45 patients were compared between the low- and high-risk (i.e., ISUP grades III-V) groups and between patients with or without PSMs after RP. Multivariate logistic regression analysis was used to identify the significant predictors of placement in the high-risk group and PSMs.
The DCE parameter was significantly higher in the high-risk group than in the low-risk group ( = 0.028) and was also a significant predictor of placement in the high-risk group (odds ratio [OR] = 1.032, 95% confidence interval [CI] = 1.005-1.060, = 0.021). Patients with PSMs had significantly higher prostate-specific antigen (PSA) titers, positive biopsy core percentages, , , and than others (all < 0.05). Of these, positive biopsy core percentage (OR = 1.035, 95% CI = 1.003-1.068, = 0.032) and (OR = 1.078, 95% CI = 1.012-1.148, = 0.020) were significant predictors of PSMs.
Preoperative DCE-MRI parameters, specifically and could potentially serve as preoperative imaging biomarkers for postoperative PCa prognosis based on their predictability of PCa risk group and PSM on RP, respectively.
国际泌尿病理学会(ISUP)分级和根治性前列腺切除术(RP)后的手术切缘阳性(PSM)可能反映前列腺癌(PCa)患者的预后。本研究旨在探讨动态对比增强磁共振成像(DCE-MRI)参数(即 、 以及初始面积曲线下积分(IAUC))能否预测RP后的ISUP分级和PSM。
45例PCa患者术前行DCE-MRI检查。比较45例患者的临床特征和DCE-MRI参数在低风险和高风险(即ISUP III-V级)组之间以及RP后有无PSM的患者之间的差异。采用多因素逻辑回归分析确定高危组和PSM的显著预测因素。
高危组的DCE参数 显著高于低危组( = 0.028),且也是高危组的显著预测因素(比值比[OR] = 1.032,95%置信区间[CI] = 1.005 - 1.060, = 0.021)。有PSM的患者前列腺特异性抗原(PSA)滴度、阳性活检核心百分比、 、 以及 均显著高于其他患者(均 < 0.05)。其中,阳性活检核心百分比(OR = 1.035,95% CI = 1.003 - 1.068, = 0.032)和 (OR = 1.078,95% CI = 1.012 - 1.148, = 0.020)是PSM的显著预测因素。
术前DCE-MRI参数,特别是 和 ,分别基于其对PCa风险组和RP时PSM的预测能力,有可能作为术后PCa预后的术前影像生物标志物。