235例磁共振与经直肠超声认知融合下经会阴前列腺穿刺分析

白红松; 陈永海; 胡林军; 谢成明; 单兴利; 卢德虎; 王栋; 毕新刚; 寿建忠; 李长岭; 邢念增

doi:10.13201/j.issn.1001-1420.2020.12.002

235例磁共振与经直肠超声认知融合下经会阴前列腺穿刺分析

- 1. 国家癌症中心国家肿瘤临床医学研究中心中国医学科学院北京协和医学院肿瘤医院泌尿外科(北京, 100021);
- 2. 北京市朝阳区桓兴肿瘤医院泌尿外科
基金项目:
北京市朝阳区科技计划项目基金(No:CYSF1918)

详细信息

通讯作者: 胡林军,E-mail:15810349445@163.com

中图分类号: R737.25

收稿日期: 2020-05-16

Magnetic resonance imaging-transperineal ultrasound cognitive fusion biopsy on the diagnosis of prostate cancer: a study of 235 cases

- 1. Department of Urology, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China;
- 2. Department of Urology, Cancer Hospital of HuanXing ChaoYang District Beijing

More Information

Corresponding author: HU Linjun, E-mail: 15810349445@163.com

Received Date: 16 May 2020

摘要

摘要: 目的:探究磁共振(MRI)-经直肠超声(TRUS)认知融合引导下经会阴前列腺靶向穿刺活检与经会阴前列腺系统穿刺活检对前列腺癌的检出率的差异性,并分析检出率的影响因素。方法:回顾性分析中国医学科学院肿瘤医院2017年12月~2019年12月规范的影像数据系统第2版评分≥3分的行经会阴前列腺穿刺活检的患者资料。同时行2~4针靶向穿刺活检和12针系统穿刺活检,比较二者在前列腺癌检出率方面的差异性。结果:共127例证实为前列腺癌,其中经认知融合靶向穿刺检出前列腺癌105例,系统穿刺检出前列腺癌117例,两者在前列腺癌检出率方面差异无统计学意义(χ²=1.229,P=0.268)。在以PSA高低的分组中,两者在PSA＜4 ng/mL、4ng/mL≤PSA ＜10 ng/mL、10 ng/mL≤PSA＜20 ng/mL及PSA≥20 ng/mL4组的检出率差异均无统计学意义(P＞0.05),以PSA密度分组中,两者检出率差异无统计学意义(P＞0.05)。二者联合检出率为54.04%,均高于两者单独的检出率,且检出率的高低与PSA水平及PSA密度相关。结论:MRI-TRUS认知融合引导的经会阴靶向穿刺活检与系统的前列腺穿刺活检在前列腺癌的检出率方面差异无统计学意义,经会阴前列腺靶向穿刺活检仍不能代替系统前列腺穿刺活检,二者的结合可提高前列腺癌的检出率。
- 前列腺癌 /
- mpMRI-TRUS认知融合 /
- 靶向穿刺活检 /
- 系统穿刺活检
Abstract: Objective: To investigate the difference in the detection rate of prostate cancer between perineal prostate systematic biopsy and perineal prostate targeted biopsy under the guidance of magnetic resonance imaging(MRI)-transrectal ultrasound(TRUS) cognitive fusion. Method: A retrospective analysis was performed on the data of patients with prostatic nodules or obvious abnormal signals, namely pi-rads V2 score≥3 points after mpMRI examination, who underwent perineal prostate puncture in Cancer Hospital of Chinese Academy of Medical Sciences from December 2017 to December 2019.Two to four needles targeted biopsy and 12 needles systematic biopsy were performed to compare the difference in prostate cancer detection rate between targeted biopsy and systematic biopsy. Result: A total of 127 cases were identified as prostate cancer, among which 105 cases were detected by targeted biopsy of cognitive fusion and 117 cases by systematic biopsy. There was no significant difference in the detection rate of prostate cancer(χ²= 1.229, P=0.268). There was no significant difference in detection rate among the four groups of PSA＜4 ng/mL, 4 ng/mL≤PSA＜10 ng/mL, 10 ng/mL≤PSA＜20 ng/mL or PSA≥20 ng/mL(all P＞0.05). In the PSA density group, there was no significant difference in detection rate of the two groups(all P＞0.05). The detection rate of combined targeted biopsy and systematic biopsy was 54.04%, which was higher than that of the two methods applied alone, and the detection rate was correlated with the PSA value and PSA density.Conclusion: There was no statistically significant difference in the detection rate of prostate cancer between targeted biopsy and systematic biopsy guided by MRI-TRUS cognitive fusion. However, targeted biopsy is still not a substitute for systematic biopsy, and the combination of the two can improve the detection rate of prostate cancer.
- prostate cancer /
- mpMRI-TURS cognitive fusion /
- targeted biopsy /
- systematic biopsy

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参考文献(26)

[1]	Siegel RL,Miller KD,Jemal A.Cancer statistics[J].CA Cancer J Clin,2019,69(1):7-34.
[2]	郑荣寿,孙可欣,张思维,等.2015年中国恶性肿瘤流行情况分析[J].中华肿瘤杂志,2019,41(1):19-28.
[3]	Chen W,Zheng R,Baade PD,et al.Cancer statistics in China,2015[J].CA Cancer J Clin,2016,66(2):115-132.
[4]	Drost FH,Osses DF,Nieboer D,et al.Prostate MRI,with or without MRI-targeted biopsy,and systematic biopsy for detecting prostate cancer[J].Cochrane Database Syst Rev,2019,4(4):CD012663.
[5]	Weinreb JC,Barentsz JO,Choyke PL,et al.PI-RADS prostate imaging-reporting and data system:2015,version 2[J].Eur Urol,2016,69(1):16-40.
[6]	Eichler K,Hempel S,Wilby J,et al.Diagnostic value of systematic biopsy methods in the investigation of prostate cancer:a systematic review[J].J Urol,2006,175(5):1605-1612.
[7]	Mottet N,Clarke N,De Santis M,et al.Implementing newer agents for the management of castrateresistant prostate cancer:what is known and what is needed[J]?BJU Int,2015,115(3):364-372.
[8]	Marra G,Gontero P,Valerio M.Changing the prostate cancer management pathway:why focal therapy is a step forward[J].Arch Esp Urol,2016,69(6):271-280.
[9]	Futterer JJ,Briganti A,De Visschere P,et al.Can clinically significant prostate cancer be detected with multiparametric magnetic resonance imaging?A systematic review of the literature[J].Eur Urol,2015,68(6):1045-1053.
[10]	Woodrum DA,Gorny KR,Mynderse LA.MR-Guided Prostate Interventions[J].Top Magn Reson Imaging,2018,27(3):141-151.
[11]	Brown LC,Ahmed HU,Faria R,et al.Multiparametric MRI to improve detection of prostate cancer compared with transrectal ultrasound-guided prostate biopsy alone:the PROMIS study[J].Health Technol Assess,2018,22(39):1-176.
[12]	Kasivisvanathan V,Rannikko AS,Borghi M,et al.MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis[J].N Engl J Med,2018,378(19):1767-1777.
[13]	Wegelin O,van Melick HHE,Hooft L,et al.Comparing three different techniques for magnetic resonance imaging-targeted prostate biopsies:a systematic review of in-bore versus magnetic resonance imaging-transrectal ultrasound fusion versus cognitive registration.Is there a preferred technique?[J].Eur Urol,2017,71(4):517-531.
[14]	Wegelin O,Exterkate L,van der Leest M,et al.The FUTURE Trial:a multicenter randomised controlled trial on target biopsy techniques based on magnetic resonance imaging in the diagnosis of prostate cancer in patients with prior negative biopsies[J].Eur Urol,2019,75(4):582-590.
[15]	Haffner J,Lemaitre L,Puech P,et al.Role of magnetic resonance imaging before initial biopsy:comparison of magnetic resonance imaging-targeted and systematic biopsy for significant prostate cancer detection[J].BJU Int,2011,108(8Pt2):E171-E178.
[16]	Marra G,Ploussard G,Futterer J,et al.Controversies in MR targeted biopsy:alone or combined,cognitive versus software-based fusion,transrectal versus transperineal approach?[J].World J Urol,2019,37(2):277-287.
[17]	Siddiqui MM,Rais-Bahrami S,Turkbey B,et al.Comparison of MR/ultrasound fusion-guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancerControversies in MR targeted biopsy:alone or combined,cognitive versus software-based fusion,transrectal versus transperineal approach[J].JAMA,2015,27(313):390-397.
[18]	熊轶,张古田,汪维,等.MRI/US成像融合引导的经会阴前列腺穿刺活检的单中心研究[J].临床泌尿外科杂志,2018,33(1):39-43.
[19]	Salami SS,Ben-Levi E,Yaskiv O,et al.In patients with a previous negative prostate biopsy and a suspicious lesion on magnetic resonance imaging,is a 12-core biopsy still necessary in addition to a targeted biopsy?[J].BJU Int,2015,115(4):562-570.
[20]	Schoots IG,Roobol MJ,Nieboer D,et al.Magnetic resonance imaging-targeted biopsy may enhance the diagnostic accuracy of significant prostate cancer detection compared to standard transrectal ultrasound-guided biopsy:a systematic review and meta-analysis[J].Eur Urol,2015,68(3):438-450.
[21]	Schouten MG,van der Leest M,Pokorny M,et al.Why and where do we miss signifcant prostate cancer with multi-parametric magnetic resonance imaging followed by magnetic resonance-guided and transrectal ultrasound-guided biopsy in biopsy-naive men?[J].Eur Urol,2017,71(6):896-903.
[22]	Albisinni S,Aoun F,Noel A,et al.Are concurrent systematic cores needed at the time of targeted biopsy in patients with prior negative prostate biopsies?[J].Prog Urol,2018,28(1):18-24.
[23]	Radtke JP,Kuru TH,Boxler S,et al.Comparative analysis of transperineal template saturation prostate biopsy versus magnetic resonance imaging targeted biopsy with magnetic resonance imaging-ultrasound fusion guidance[J].J Urol,2015,193(1):87-94.
[24]	胡林军,寿建忠,邢念增,等.经会阴认知融合MRI前列腺靶向穿刺71例单中心临床研究[J].中国临床医生杂志,2018,46(8):935-938.
[25]	李德润,刘毅,李志华,等.磁共振与经直肠超声认知融合引导的经直肠前列腺靶向穿刺活检614例单中心临床研究[J].生物医学工程学杂志,2020,37(2):1-5.
[26]	Waqas M,Shohab D,Khawaja MA,et al.Outcome Of Trans Rectal Ultrasound Guided Twelve Core Biopsy Of Prostate For The Detection Of Prostate Cancer-A Single Centre Experience[J].J Ayub Med Coll Abbottabad,2018,30(1):49-53.