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超声引导下经会阴与经直肠前列腺穿刺活检:诊断准确性和并发症发生率的Meta分析

Ultrasound-guided transperineal vs transrectal prostate biopsy: A meta-analysis of diagnostic accuracy and complication rates.

作者信息

Wu Tao, Xing Yanchun

机构信息

Department of Urology, Huangshan City People's Hospital, Huangshan , 245000, China.

Department of Medicine, Huangshan Vocational Technical College, Huangshan, 245000, China.

出版信息

Open Med (Wars). 2024 Oct 2;19(1):20241039. doi: 10.1515/med-2024-1039. eCollection 2024.

DOI:10.1515/med-2024-1039
PMID:39381428
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11459270/
Abstract

OBJECTIVES

We conducted a systematic review to compare the diagnostic utility of ultrasound-guided transperineal (TP) and transrectal (TR) prostate biopsy methods for prostate cancer detection.

METHODS

We searched PubMed, Embase, Web of Science, and Cochrane databases up to October 30, 2023, for relevant studies, screening the literature and assessing bias independently.

RESULTS

Eleven trials were analyzed using relative risk and 95% confidence intervals, with no evidence of publication bias. Diagnostic rates showed no significant difference between TP and TR biopsies (mean difference [MD]: 1.03, 95% confidence interval [CI]: 0.91-1.14, = 0.56). Prostate volume analysis also showed no significant difference (MD: -0.07, 95% CI: -0.73 to 0.59, < 0.0001, combined effect size = 0.83). Similarly, PSA levels were comparable between TP and TR biopsies (MD: 0.93, 95% CI: -0.44 to 2.30, < 0.0001, combined effect size = 0.18).

CONCLUSION

Both biopsy methods exhibit similar diagnostic accuracy; however, TP has a lower risk of biopsy.

摘要

目的

我们进行了一项系统评价,以比较超声引导下经会阴(TP)和经直肠(TR)前列腺穿刺活检方法在前列腺癌检测中的诊断效用。

方法

我们检索了截至2023年10月30日的PubMed、Embase、Web of Science和Cochrane数据库,查找相关研究,独立筛选文献并评估偏倚。

结果

使用相对风险和95%置信区间对11项试验进行了分析,没有发表偏倚的证据。TP和TR活检之间的诊断率没有显著差异(平均差[MD]:1.03,95%置信区间[CI]:0.91 - 1.14,P = 0.56)。前列腺体积分析也没有显著差异(MD:-0.07,95% CI:-0.73至0.59,P < 0.0001,合并效应量I² = 0.83)。同样,TP和TR活检之间的前列腺特异性抗原(PSA)水平相当(MD:0.93,95% CI:-0.44至2.30,P < 0.0001,合并效应量I² = 0.18)。

结论

两种活检方法的诊断准确性相似;然而,TP活检的风险较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14c4/11459270/4369414a78e2/j_med-2024-1039-fig004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14c4/11459270/abeacc0dffaa/j_med-2024-1039-fig001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14c4/11459270/b13dfe39e107/j_med-2024-1039-fig002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14c4/11459270/2c8e32dc4de4/j_med-2024-1039-fig003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14c4/11459270/4369414a78e2/j_med-2024-1039-fig004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14c4/11459270/abeacc0dffaa/j_med-2024-1039-fig001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14c4/11459270/b13dfe39e107/j_med-2024-1039-fig002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14c4/11459270/2c8e32dc4de4/j_med-2024-1039-fig003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14c4/11459270/4369414a78e2/j_med-2024-1039-fig004.jpg

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本文引用的文献

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Urol Ann. 2024 Apr-Jun;16(2):155-159. doi: 10.4103/ua.ua_128_22. Epub 2024 Apr 18.
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Early Detection of Prostate Cancer in the European Union: Combining Forces with PRAISE-U.欧盟的前列腺癌早期检测:与 PRAISE-U 联合力量。
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Transperineal Prostate Biopsy Targeted by Magnetic Resonance Imaging Cognitive Fusion.
磁共振成像认知融合引导下经会阴前列腺穿刺活检
Diagnostics (Basel). 2023 Apr 8;13(8):1373. doi: 10.3390/diagnostics13081373.
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Prostate Cancer Detection and Complications of Transperineal Versus Transrectal Magnetic Resonance Imaging-fusion Guided Prostate Biopsies.经会阴与经直肠磁共振成像融合引导前列腺活检对前列腺癌的检出及并发症的影响。
Urology. 2023 Jul;177:109-114. doi: 10.1016/j.urology.2023.04.003. Epub 2023 Apr 13.
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Transrectal versus transperineal prostate biopsy in detection of prostate cancer: a retrospective study based on 452 patients.经直肠与经会阴前列腺穿刺活检诊断前列腺癌的对比:一项基于 452 例患者的回顾性研究。
BMC Urol. 2023 Jan 28;23(1):11. doi: 10.1186/s12894-023-01176-y.
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