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[1]张一然,潘盼,连振鹏,等.磁共振扫描对经直肠超声引导前列腺穿刺活检的影响[J].天津医科大学学报,2017,23(02):99-102.
 ZHANG Yi-ran,PAN Pan,LIAN Zhen-peng,et al.Effect of magnetic resonance imaging scan on the?transrectal ultrasound?prostate biopsy[J].Journal of Tianjin Medical University,2017,23(02):99-102.
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
23卷
期数:
2017年02期
页码:
99-102
栏目:
专题报道
出版日期:
2017-03-20

文章信息/Info

Title:
Effect of magnetic resonance imaging scan on the?transrectal ultrasound?prostate biopsy
文章编号:
1006-8147(2017)02-0099-04
作者:
张一然潘盼连振鹏郑小康刘冉录
(天津医科大学第二医院泌尿外科,天津市泌尿外科研究所,天津300211)
Author(s):
ZHANG Yi-ran PAN Pan LIAN Zhen-peng ZHENG Xiao-kang LIU Ran-lu.
(Department of Urology, The Second Hospital,Tianjin Medical University, Tianjin Institute of Urology, Tianjin 300211, China)
关键词:
前列腺穿刺磁共振前列腺癌
Keywords:
prostatebiopsy magnetic resonance imaging prostate cancer.
分类号:
R737.25
DOI:
-
文献标志码:
A
摘要:
目的:研究前列腺穿刺前行磁共振(MRI)扫描对结果的影响,并分析其对于前列腺癌(PCa)诊断的帮助。方法:回顾性选取行经直肠超声引导前列腺穿刺的住院患者,按照穿刺前是否行MRI扫描分为两组,调查其病理结果、穿刺针数、前列腺特异性抗原(PSA)、前列腺体积(PV)等,对确诊PCa患者,统计其阳性针数占比、Gleason评分、局部侵犯神经和骨转移情况。使用统计学方法分析MRI扫描对穿刺的影响。结果:共372例患者纳入统计,其中行MRI患者255例,未行MRI患者117例。MRI组患者穿刺阳性率(52.2%vs41.0%, P=0.046)、高危患者比例(78.9%vs64.6%, P=0.049)、阳性针数占比(69.9%vs54.2%, P=0.048)均高于Non-MRI组。年龄(P=0.116)、PSA(P=0.078)、f/tPSA(P=0.329)、PV(P=0.291)、PSAD(P=0.302)之间均无组间差异,在穿刺针数(P=0.001)、阳性针数占比(P=0.039)中存在统计学差异。结论:前列腺穿刺作为PCa术前确诊最重要的技术手段,有必要在前列腺穿刺前为所有可疑患者行MRI检查,在此基础上增加穿刺针数,以获得更高的穿刺效率。
Abstract:
Objective: To investigate the effect of the magnetic resonance imaging(MRI) for prostate biopsy and analyze its assistance with the diagnosis of prostate cancer(PCa). Methods: Patients who had undergone a transrectal ultrasound guided prostate biopsy were retrospectively included in the research. All the participants were divided into two groups according to whether or not they had a MRI scan before biopsy. The pathological results, the number of biopsy cores, the prostate specific antigen (PSA), and prostate volume (PV) of all the patients were recorded. Proportion of positive cores, Gleason scores, ECT bone scan and local neural invasion results were investigated in patients with PCa. The effect of MRI scan on biopsy was analyzed by statistical software.Results: A total of 372 patients were included in the research, including 255 patients with MRI and 117 patients without MRI. The median age was 70.5, the total positive rate was 48.7% and the high-risk patients (Gleason score over 7 points or with bone metastases or local neural invasion) accounted for 65.7% of PCa patients. The positive rate of biopsy in MRI group was higher than non-MRI group (52.2%vs41.0%, P=0.046), high-risk patients proportion in MRI group was higher than non-MRI group (69.9%vs54.2%, P=0.049), and Proportion of positive cores was significantly higher than non-MRI group (78.9%vs64.6%, P=0.048). There were no significant differences in age (P=0.116), PSA (P=0.078), f/tPSA (P=0.329), PV (P=0.291), PSAD (P=0.302) between the two groups, while the number of biopsy cores (P=0.001), proportion of positive cores (P=0.039) had significant differences between the two groups.Conclusion: Prostate biopsy may be the most important technique of PCa diagnosis. MRI scan could be necessary for all the suspectedpatients before a prostate biopsy in order to increase the number of biopsy cores and obtain higher biopsy efficiency.

参考文献/References:

[1]Siegel R L, Miller K D, Jemal A. Cancer statistics[J]. JAMA, 2013, 310(9): 982

[2]Chen W Q, Zheng R S, Baade P D, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2): 115

[3]Chen R, Zhou L Q, Cai X B, et al. Percent free prostate-specific antigen is effective to predict prostate biopsy outcome in Chinese men with prostate-specific antigen between 10.1 and 20.0 ngml(1)[J]. Asian J Androl, 2015, 17(6): 1017

[4]李慧,姜行康,齐士勇,等.前列腺穿刺标本中神经周围侵犯对根治术后患者预后的影响[J].天津医科大学学报,2015,21(3):233

[5]Chen R, Ren S, Ming K Y, et al. Prostate cancer in Asia:A collaborative report[J]. Asian J Urol, 2015, 1(1): 15

[6]陈锐,谢立平,周利群,等.中国前列腺癌联盟成员医院前列腺穿刺活检现状的调查报告[J].中华泌尿外科杂志,2015,36(5):342

[7]刘丹丹,张惠萍,汪向前,等.经直肠前列腺穿刺活检个体化方案的制定及其影响因素[J].现代医学,2016,52(8):1135

[8]虞巍,阿不都热合曼·帕塔,何群,等.前列腺体积对不同前列腺穿刺方案诊断前列腺癌的影响[J].北京大学学报:医学版,2010,42(4):400

[9]Komai Y, Numao N, Yoshida S, et al. High diagnostic ability of multiparametric magnetic resonance imaging to detect anterior prostate cancer missed by transrectal 12-Core biopsy[J]. J Urol , 2013, 190(3): 867

[10]Turkbey B, Mani H, Shah V, et al. Multiparametric 3T prostate magnetic resonance imaging to detect cancer: histopathological correlation using prostatectomy specimens processed in customized magnetic resonance imaging based molds[J]. J Urol , 2011, 186(5): 1818

[11]Isebaert S, Van den Bergh L, Haustermans K, et al. MultiparametricMri for Prostate Cancer Localization in Correlation to Whole-Mount Histopathology [J]. J MagnReson Imaging, 2013, 37(6): 1392

[12]章绪辉.3.0T磁共振成像在前列腺癌诊断中的应用研究[D].广州:南方医科大学,2014

[13]Moore C M, Robertson N L, Arsanious N A, et al. Image-Guided prostate biopsy using magnetic resonance Imaging-Derived targets: a systematic review[J]. EurUrol, 2013, 63(1): 125

[14]Lamb B W, Tan Wei SHEN, Rehman A, et al. Isprebiopsy MRI good enough to avoid prostate biopsy? a cohort study over a 1-Year period[J]. ClinGenitourin Cancer, 2015, 13(6): 512

[15]Sonn G A, Chang E, Natarajan S, et al. Value of targeted prostate biopsy using magnetic Resonance-Ultrasound fusion in men with prior negative biopsy and elevated prostate-specific antigen[J]. EurUrol, 2014, 65(4): 809

[16]Bokhorst L P, Zhu X Y, Bul M, et al. Positive predictive value of prostate biopsy indicated by prostate-specific-antigen-based prostate cancer screening: trends over time in a European randomized trial[J]. BJU Int, 2012, 110(11): 1654

[17]刘冉录,张一然,徐勇.多参数磁共振成像引导下前列腺靶向穿刺活检的临床应用进展[J].中华泌尿外科杂志,2015,36(7):555

[18]Bjurlin M A, Mendhiratta N, Wysock J S, et al. Multiparametric MRI and targeted prostate biopsy:Improvements in cancer detection,localization,and risk assessment[J]. Cent European JUrol, 2016, 69(1): 9

[19]Moore C M, Robertson N L, Arsanious N A, et al. Image-Guided prostate biopsy using magnetic resonance Imaging-Derived targets: a systematic review[J]. EurUrol, 2013, 63(1): 125

[20]Mendhiratta N, Meng X S, Taneja S S. Using multiparametric MRI to `personalize’ biopsy for men[J]. CurrOpinUrol, 2015, 25(6): 498

[21] Costa D N, Bloch B N, Yao D F, et al. Diagnosis of relevant Ppostate cancer using supplementary cores from magnetic resonance imaging-prompted areas following multiple failed biopsies[J]. MagnReson Imaging, 2013, 31(6): 947

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备注/Memo

备注/Memo:
基金项目 天津市自然科学基金重点项目基金资助(15JCZDJC35900);天津市卫生局重点攻关项目(13KG141)

作者简介 张一然(1991-),男,硕士在读,研究方向:泌尿外科;通信作者:刘冉录,E-mail:liuranlu1976@126.com。

更新日期/Last Update: 2017-03-28