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中华腔镜泌尿外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (05) : 293 -296. doi: 10.3877/cma.j.issn.1674-3253.2019.05.002

所属专题： 文献；

临床研究

两种核磁靶向穿刺诊断有临床意义前列腺癌精确性的比较
张凯1, 张志鹏2, 朱刚1,†(), 刘明2   
  1. 1. 100015　北京和睦家医院泌尿外科
    2. 100073　北京医院泌尿外科
  • 收稿日期:2018-08-13 出版日期:2019-10-01
  • 通信作者: 朱刚

Comparison of two different approaches of MRI-targeted biopsy on the diagnosis of clinically significant prostate cancer

Kai Zhang1, Zhipeng Zhang2, Gang Zhu1,†(), Ming Liu2   

  1. 1. Department of Urology, Beijing United Family Hospital and Clinics, Beijing 100015, China
    2. Department of Urology, Beijing Hospital, Beijing 100730, China
  • Received:2018-08-13 Published:2019-10-01
  • Corresponding author: Gang Zhu
  • About author:
    Corresponding author: Zhu Gang, Email:
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张凯, 张志鹏, 朱刚, 刘明. 两种核磁靶向穿刺诊断有临床意义前列腺癌精确性的比较[J]. 中华腔镜泌尿外科杂志(电子版), 2019, 13(05): 293-296.

Kai Zhang, Zhipeng Zhang, Gang Zhu, Ming Liu. Comparison of two different approaches of MRI-targeted biopsy on the diagnosis of clinically significant prostate cancer[J]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(05): 293-296.

目的

比较两种不同方式核磁（MRI）靶向穿刺诊断有临床意义前列腺癌的准确性。

方法

入组2015～2017年北京和睦家医院45例行认知融合穿刺患者，北京医院87例行MRI引导下穿刺患者，对比两组患者年龄、前列腺特异抗原（PSA）、前列腺体积、前列腺影像报告和数据系统（PI-RADS）评分等临床资料，分析穿刺结果中前列腺癌以及有临床意义前列腺癌的检出率。

结果

MRI引导穿刺组患者年龄明显高于认知融合穿刺组；而两组患者PSA、前列腺体积、PI-RADS评分差异均无统计学意义。在总体前列腺癌检出率方面，MRI引导穿刺组为52.9%，认知融合穿刺组为31.1% （P<0.05）；在有临床意义前列腺癌检出率方面，MRI引导组为29.9%，认知融合穿刺组为20.0%（P>0.05）。

结论

MRI引导穿刺与认知融合穿刺对于诊断有临床意义前列腺癌精确性都较高，但MRI引导穿刺在总体前列腺癌检出率方面更有优势。

关键词: 核磁靶向穿刺, 前列腺癌, 前列腺穿刺活检, 诊断
Objective

To compare the diagnosis accuracy of clinically significant prostate cancer by two different MRI-targeted biopsy approaches.

Methods

A total of 45 men from Beijing United Family Hospital undergoing cognitive biopsy and 87 men from Beijing Hospital undergoing in-bore biopsy were included in the study from 2015 to 2017. The patients age, PSA, prostate volume, PI-RADS, overall prostate detection rate and clinically significant prostate cancer detection rate were compared and analyzed.

Results

The age in in-bore biopsy group was higher than cognitive biopsy group. There was no significant difference in PSA, prostate volume, and distribution of PI-RADS between the two groups. The overall prostate cancer detection rate was 52.9% by in-bore biopsy and 31.1% by cognitive biopsy (P<0.05). The clinically significant prostate cancer detection rate was 29.9% by in-bore biopsy and 20.0% by cognitive biopsy (P>0.05), respectively.

Conclusions

Both biopsies had good performance in clinically significant prostate cancer detection. But in-bore biopsy showed remarkably higher overall prostate cancer detection rate compared with cognitive biopsy.

Key words: MRI-targeted biopsy, Prostate carcinoma, Prostate biopsy, Diagnosis
图2 列腺MRI引导穿刺手术实景，2a屏幕中出现穿刺路径示意图，2b在核磁室穿刺
表1 两组患者一般资料对比
组别 例数 年龄（岁，±s） PSA（μg/L，±s） 体积（ml，±s） PI-RADS [例（%）]
2分 3分 4分 5分 ≥3分
认知融合穿刺组 45 60.0±8.0 11.3±15.5 49.3±21.9 9(20.0) 14(31.1) 15(33.3) 7(15.6) 36(80.0)
MRI引导穿刺组 87 69.7±7.0 7.2±50 48.2±21.1 7(8.0) 25(28.7) 47(54.0) 8(9.2) 80(92.0)
统计值 ? t=-7.165 t=1.702 t=0.289 χ2=1.636
P值 ? <0.001 0.095 0.773 0.201
表2 两种穿刺方式结果对比[例（%）]
组别 例数 前列腺癌检出率 有临床意义前列腺癌数量检出率
认知融合穿刺组 45 14（31.1） 9（20.0）
MRI引导穿刺组 87 46（52.9） 26（29.9）
χ2值 ? 5.665 1.580
P值 ? 0.017 0.209
[1]
Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012[J]. CA Cancer J Clin, 2015, 65(2): 87-108.
[2]
Diaz de Leon A, Costa D, Pedrosa I. Role of multiparametric mr imaging in malignancies of the urogenital tract[J]. Magn Reson Imaging Clin N Am, 2016, 24(1): 187-204.
[3]
冼土增，张俊夫，罗飞, 等. 多参数磁共振成像联合四基因模型提高前列腺癌早期诊断效能的临床研究[J/CD]. 中华腔镜泌尿外科杂志(电子版), 2018, 12(3): 149-153.
[4]
Zhang K, Bangma CH, Roobol MJ. Prostate cancer screening in Europe and Asia[J]. Asian J Urol, 2017, 4(2): 86-95.
[5]
Wong MC, Goggins WB, Wang HH, et al. Global incidence and mortality for prostate cancer: analysis of temporal patterns and trends in 36 countries[J]. Eur Urol, 2016, 70(5): 862-874.
[6]
Center MM, Jemal A, Lortet-Tieulent J, et al. International variation in prostate cancer incidence and mortality rates[J]. Eur Urol, 2012, 61(6): 1079-1092.
[7]
Barentsz JO, Richenberg J, Clements R, et al. ESUR prostate MR guidelines 2012[J]. Eur Radiol, 2012, 22(4): 746-757.
[8]
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.
[9]
Wysock JS, Mendhiratta N, Zattoni F, et al. Predictive value of negative 3T multiparametric magnetic resonance imaging of the prostate on 12-core biopsy results[J]. BJU Int, 2016, 118(4): 515-520.
[10]
Pokorny MR, de Rooij M, Duncan E, et al. Prospective study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy versus magnetic resonance (MR) imaging with subsequent MR-guided biopsy in men without previous prostate biopsies[J]. Eur Urol, 2014, 66(1): 22-29.
[11]
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(8 Pt 2): E171-178.
[12]
Schröder FH, Hugosson J, Roobol MJ, et al, Screening and prostate-cancer mortality in a randomized European study[J]. N Engl J Med, 2009, 360(13): 1320-1328.
[13]
Schroder FH, Hugosson J, Roobol MJ, et al. Prostate-cancer mortality at 11 years of follow-up[J]. N Engl J Med, 2012, 366(11): 981-990.
[14]
Schröder FH, Hugosson J, Roobol MJ. Roobol, et al. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up[J]. Lancet, 2014, 384(9959): 2027-2035.
[15]
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.
[16]
Chen R, Ren S, Yiu MK, et al. Prostate cancer in Asia: A collaborative report[J]. Asian J Urol, 2014, 1(1): 15-29.
[17]
Ito K. Prostate cancer in Asian men[J]. Nat Rev Urol, 2014，11(4): 197-212.
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