前列腺影像报告及资料系统评分与磁共振靶向活检病理结果的关系  

Analysis of the relationship between PI-RADS scores and the pathological results of targeted biopsy based on MRI

作　　者：王亚民[1] 尚金伟 董来 梁玲辉 赵睿哲[1] 梁超[1] 王尚乾[1] 夏炜 成功[1] 华立新[1] Wang Yamin;Shang Jinwei;Dong Lai;Liang Linghui;Zhao Ruizhe;Liang Chao;Wang Shangqian;Xia Wei;Cheng Gong;Hua Lixin(Department of Urology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院泌尿外科,南京210029

出　　处：《中华肿瘤杂志》2023年第11期942-947,共6页Chinese Journal of Oncology

摘　　要：目的探究前列腺影像报告及资料系统(PI-RADS)评分与经会阴磁共振超声融合靶向活检病理结果的关系。方法收集2019年6月至2022年3月于南京医科大学第一附属医院泌尿外科行经会阴磁共振超声融合靶向穿刺活检的517例PI-RADS评分为4~5分患者的临床资料、MRI资料及前列腺穿刺活检病理结果。按PI-RADS评分将患者分为4分组(369例)和5分组(148例),比较两组间前列腺穿刺活检病理阴性及世界卫生组织/国际泌尿系统病理学会(WHO/ISUP)分级的分布、前列腺癌检出率、临床有意义前列腺癌(CsPCa)检出率。结果517例患者中,前列腺癌检出率为77.8%(402/517),CsPCa检出率为66.7%(345/517)。PI-RADS评分4分组前列腺穿刺活检病理阴性及WHO/ISUP分级为1、2、3、4和5级患者分别有104例(28.2%)、47例(12.7%)、74例(20.1%)、63例(17.1%)、68例(18.4%)和13例(3.5%),5分组分别有11例(7.4%)、10例(6.8%)、33例(22.3%)、33例(22.3%)、39例(26.4%)和22例(14.9%),差异具有统计学意义(P<0.001)。PI-RADS评分4分组前列腺癌检出率和CsPCa检出率分别为71.8%(265/369)和59.1%(218/369),均低于5分组[92.6%(137/148)和85.8%(127/148),均P<0.001]。PI-RADS评分4分组患者中,WHO/ISUP分级为4~5级的患者占22.0%(81/369),低于5分组[41.2%(61/148),P<0.001]。将517例患者按PSA分层后,在379例PSA<10 ng/ml的患者中,PI-RADS评分4分组和5分组前列腺穿刺活检病理阴性及WHO/ISUP分级为1、2、3、4和5级的分布差异有统计学意义(P<0.001);PI-RADS评分4分组前列腺癌检出率和CsPCa检出率分别为70.9%(217/306)和56.2%(172/306),均低于PI-RADS评分5分组[87.7%(64/73)和80.8%(59/73);P=0.003,P<0.001]。在138例PSA为10~20 ng/ml的患者中,PI-RADS评分4分组和5分组前列腺穿刺活检病理阴性及WHO/ISUP分级为1、2、3、4和5级的分布差异有统计学意义(P=0.011);PI-RADS评分4分组前列腺癌检出率和CsPCa检出率分别为76.2%(48/63)和73.0%(46/63),均低于PI-RADS评分5分组[97Objective To analyze the relationship between Prostate Imaging Reporting and Data System(PI-RADS)scores and the pathological results of transperineal magnetic resonance-ultrasound fusion guided biopsy.Methods The clinical data,magnetic resonance imaging(MRI)results and prostate puncture biopsies of 517 patients who were assigned to PI-RADS score of 4 or 5 and underwent transperineal magnetic resonance-ultrasound fusion guided biopsy at The First Affiliated Hospital of Nanjing Medical University from June 2019 to March 2022 were retrospectively analyzed.Patients were divided into the PI-RADS 4 and PI-RADS 5 groups according to their PI-RADS scores and were stratified by their prostate specific antigen(PSA)values(PSA<10 ng/ml vs.PSA 10-20 ng/ml).The pathological negative rates from the biopsy,the distribution of the grade groups according to the grading system by World Health Organization/International Society of Urological Pathology(WHO/ISUP),the detection rates of prostate cancer(PCa)and clinically significant prostate cancer(CsPCa)between the groups were compared.Results 369 patients with a PI-RADS score of 4 and 148 patients with a PI-RADS score of 5 were included in our research.The overall detection rates of PCa and CsPCa were 77.8%(402/517)and 66.7%(345/517),respectively.In the PI-RADS 4 group,patients with prostate negative biopsies or in WHO/ISUP 1,2,3,4,or 5 grade groups accounted for 28.2%,12.7%,20.1%,17.1%,18.4%and 3.5%,respectively,whereas in the PI-RADS 5 group the rates were 7.4%,6.8%,22.3%,22.3%,26.4%,and 14.9%,respectively.The difference was statistically significant(P<0.001).The detection rates of PCa and CsPCa in the PI-RADS 4 group[71.8%(265/369)vs.59.1%(218/369),P<0.001]were lower than those of the PI-RADS 5 group[92.6%(137/148)vs.85.8%(127/148),P<0.001].In the PI-RADS 4 group,the proportion of patients classified into WHO/ISUP 4-5 grade groups was lower than that of patients in the PI-RADS 5 group[22.0%(81/369)vs 41.2%(61/148)(P<0.001)].The detection rates of PCa and CsPCa in the PSA<10 ng/ml

关 键 词：前列腺肿瘤 磁共振成像 前列腺影像报告及资料系统 穿刺活检术 有临床意义前列腺癌 

分 类 号：R445.2[医药卫生—影像医学与核医学] R737.25[医药卫生—诊断学]