Zheng Tianyun, Bi Kaipeng, Tang Yueqing, Zeng Yuan, Wang Junyan, Yan Lei
Department of Urology, Qilu Hospital of Shandong University, Jinan, 250012, Shandong, China.
Int Urol Nephrol. 2024 Mar;56(3):981-988. doi: 10.1007/s11255-023-03848-y. Epub 2023 Oct 24.
The aim of this study is to assess the precision of the Gleason score (GS) obtained through cognitive fusion-targeted biopsy (COG-TB) in comparison to transrectal ultrasonography-guided systematic biopsy (TRUS-SB), and to identify factors that can predict Gleason score upgrading (GSU) in a cohort of Chinese patients.
A final enrollment of 245 patients was recorded. Between 2020 and 2022, 132 patients underwent TRUS-SB, and 113 patients underwent COG-TB. The Chi-square test was performed to analyze the variation in downgrading, concordance, and upgrading between TRUS-SB and COG-TB. Multivariable analyses were performed to seek factors predicting Gleason score upgrading. Finally, a model which utilizes multivariable logistic regression was developed to predict the likelihood of GSU.
The concordance for TRUS-SB and COG-TB were 42.4% and 65.5%, respectively. TRUS-SB and COG-TB exhibited notable disparities in downgrading, concordance, and upgrading. Age, prostate volume, body mass index (BMI), and the biopsy modality were significant predictive factors.
COG-TB can significantly increase concordance with final histopathology. Age, prostate volume, BMI, and the biopsy modality were predictive factors of GSU.
本研究旨在评估经认知融合靶向活检（COG-TB）获得的Gleason评分（GS）与经直肠超声引导下系统活检（TRUS-SB）相比的精确性，并在中国患者队列中识别可预测Gleason评分升级（GSU）的因素。
最终记录了245例患者的入组情况。在2020年至2022年期间，132例患者接受了TRUS-SB，113例患者接受了COG-TB。进行卡方检验以分析TRUS-SB和COG-TB之间在降级、一致性和升级方面的差异。进行多变量分析以寻找预测Gleason评分升级的因素。最后，开发了一个利用多变量逻辑回归的模型来预测GSU的可能性。
TRUS-SB和COG-TB的一致性分别为42.4%和65.5%。TRUS-SB和COG-TB在降级、一致性和升级方面表现出显著差异。年龄、前列腺体积、体重指数（BMI）和活检方式是显著的预测因素。
COG-TB可显著提高与最终组织病理学的一致性。年龄、前列腺体积、BMI和活检方式是GSU的预测因素。
