穿刺活检单针阳性前列腺癌患者病理升级的相关因素分析  

Factors associated with pathological upgrading in prostate cancer patients with single-needle positive biopsy

作　　者：巩会杰 牛少曦[4] 闫永吉 陈正光[3] Gong Huijie;Niu Shaoxi;Yan Yongji;Chen Zhengguang(First Clinical School of Medicine,Beijing University of Traditional Chinese Medicine,Beijing 100700;Department of Urology,Dongzhimen Hospital,Beijing 100700;Department of Radiology,Dongzhimen Hospital,Beijing 100700;Department of Urology,First Medical Center of the Chinese PLA General Hospital,Beijing 100853)

机构地区：[1]北京中医药大学第一临床医学院,北京100700 [2]北京中医药大学东直门医院泌尿外科,北京100700 [3]北京中医药大学东直门医院放射科,北京100700 [4]中国人民解放军总医院第三医学中心泌尿外科医学部,北京100853

出　　处：《微创泌尿外科杂志》2022年第2期95-99,共5页Journal of Minimally Invasive Urology

摘　　要：目的:探讨穿刺活检单针阳性前列腺癌患者根治性前列腺切除术后病理升级的危险因素。方法:回顾性分析2017年1月至2020年1月中国人民解放军总医院第一医学中心和北京中医药大学东直门医院泌尿外科收治的前列腺穿刺活检单针阳性前列腺癌患者76例,根据术后病理是否升级分为病理升级组39例和病理未升级组37例。多因素Logistic回归分析术后病理升级的危险因素。结果:术前多参数磁共振PI-RADS评分2分者6例(7.9%),3分者22例(28.9%),4分者44例(57.9%),5分者4例(5.3%)。两组患者PI-RADS评分和tPSA差异有统计学意义(P<0.05);年龄、前列腺体积、BMI、PSAD、穿刺方式和术前临床分期差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示PI-RADS评分>3分为穿刺活检单针阳性前列腺癌术后病理升级的独立危险因素(OR=42.8,95%CI:6.6-278.2;P<0.01)。结论:基于多参数MRI的PI-RADS评分是根治性前列腺切除术后Gleason评分升高的危险因素。Objective:To investigate the risk factors of pathological upgrading after radical prostatectomy in patients with prostate cancer with single-needle positive needle biopsy.Methods:From January 2017 to January 2020,76 patients with prostate cancer with single needle positive prostate biopsy admitted to the Department of Urology of the First Medical Center of the Chinese PLA General Hospital and Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine were retrospectively analyzed.According to whether the postoperative pathology was upgraded or not,they were divided into pathological upgraded group(39 cases)and pathological unupgraded group(37cases).Multivariate logistic regression analysis was used to analyze the risk factors of postoperative pathological progression.Results:Preoperative multiparameter MRI PI-RADS score was 2 in 6 cases(7.9%),3 in 22 cases(28.9%),4 in 44 cases(57.9%)and 5 in 4 cases(5.3%).There was significant difference in PI-RADS score and tPSA between the two groups(P<0.05).There was no significant difference in age,prostate volume,BMI,PSAD,puncture method and preoperative clinical stage(P>0.05).Multivariate Logistic regression analysis showed that PIRADS>3 score was an independent risk factor for postoperative pathological progression of single-needle positive prostate cancer(OR=42.8,95%CI:6.6-278.2;P<0.01).Conclusion:PI-RADS score based on multiparametric MRI is a risk factor for Gleason score elevation after radical prostatectomy.

关 键 词：前列腺 活组织检查 多参数磁共振成像 

分 类 号：R737.25[医药卫生—肿瘤]