Li Wei, Ling Zhixin, Chen Xin, Wang Chaozhong, Guo Yunjie, Bao Jie, Huang Renpeng, Wei Xuedong
Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Imaging, The First Affiliated Hospital of Soochow University, Suzhou, China.
Quant Imaging Med Surg. 2024 Sep 1;14(9):6724-6733. doi: 10.21037/qims-23-1820. Epub 2024 Aug 28.
The rapid and accurate acquisition of prostate cancer pathological tissue is critical to prostate cancer research but has traditionally proven challenging. However, the gradual application of three-dimensional (3D) modeling in medical practice has overcome many of the related limitations. This cohort study aimed to compare the difference between a 3D stereotaxic sampling method and traditional cognitive sampling method to clarify the factors affecting sampling.
An analysis of 111 men who received radical prostatectomy for prostate cancer at The First Affiliated Hospital of Soochow University between November 2020 and April 2022 was conducted. The positive rate of the cognitive sampling method and the 3D stereotaxic sampling method and their respective influencing factors, such as age, body mass index (BMI), prostate-specific antigen (PSA), PSA density (PSAD), International Society of Urological Pathology (ISUP) grade, tumor volume, number of positive needles from perineal puncture, clinical T stage, and tumor image location, were compared and analyzed, and a cohort study was conducted.
Among the 111 patients, there were 57 cases of cognitive sampling and 54 cases of 3D stereotaxic sampling. In this study, the positive rate of cognitive sampling was 29.82% (17/57,), and the positive rate of 3D stereotaxic sampling was 61.11% (33/54), with the positive rate of 3D stereotaxic sampling being significantly higher than that of cognitive sampling (P=0.001). In cognitive sampling, tumor volume [odds ratio (OR) =1.10; 95% confidence interval (CI): 1.02-1.20], number of positive biopsy cores (OR =1.30; 95% CI: 1.06-1.60), Prostate Imaging Report and Data System (PI-RADS) score (OR =5.54; 95% CI: 1.60-19.12), and clinical T stage (OR =2.36; 95% CI: 1.31-4.25) were identified as influencing factors; in 3D stereotaxic sampling, these influencing factors were eliminated, with ORs of 1.22 (95% CI: 0.78-1.90), 0.88 (95% CI: 0.72-1.09), 1.09 (95% CI: 0.62-1.92), and 1.51 (95% CI: 0.86-2.65), respectively, representing a statistically significant difference (P<0.05).
The 3D stereotaxic sampling method can accurately obtain the required prostate cancer tissue from the prostate within a short time, and the factors affecting the positive rate of sampling can be eliminated.
快速准确地获取前列腺癌病理组织对前列腺癌研究至关重要，但传统上一直颇具挑战。然而，三维（3D）建模在医学实践中的逐步应用克服了许多相关限制。本队列研究旨在比较3D立体定向采样方法与传统认知采样方法之间的差异，以阐明影响采样的因素。
对2020年11月至2022年4月在苏州大学附属第一医院接受前列腺癌根治术的111名男性进行分析。比较并分析认知采样方法和3D立体定向采样方法的阳性率及其各自的影响因素，如年龄、体重指数（BMI）、前列腺特异性抗原（PSA）、PSA密度（PSAD）、国际泌尿病理学会（ISUP）分级、肿瘤体积、经会阴穿刺阳性针数、临床T分期和肿瘤图像位置，并进行队列研究。
111例患者中，认知采样57例，3D立体定向采样54例。本研究中，认知采样的阳性率为29.82%（17/57），3D立体定向采样的阳性率为61.11%（33/54），3D立体定向采样的阳性率显著高于认知采样（P=0.001）。在认知采样中，肿瘤体积[比值比（OR）=1.10；95%置信区间（CI）：1.02-1.20]、阳性活检核心数（OR =1.30；95%CI：1.06-1.60）、前列腺影像报告和数据系统（PI-RADS）评分（OR =5.54；95%CI：1.60-19.12）和临床T分期（OR =2.36；95%CI：1.31-4.25）被确定为影响因素；在3D立体定向采样中，这些影响因素被消除，OR分别为1.22（95%CI：0.78-1.90）、0.88（95%CI：0.72-1.09）、1.09（95%CI：0.62-1.92）和1.51（95%CI：0.86-2.65），差异有统计学意义（P<0.05）。
3D立体定向采样方法可在短时间内从前列腺中准确获取所需的前列腺癌组织，并可消除影响采样阳性率的因素。
