前列腺癌包膜外侵犯MRI分型预测腹腔镜根治性前列腺切除术后切缘阳性  

MRI classification of extraprostatic extension of prostate cancer for predicting positive surgical margin after laparoscopic radical prostatectomy

作　　者：钟超 王君广 章柯成 王菁[3] 张晓辉 张宏[3] ZHONG C hao;WANG Junguang;ZHANG Kecheng;WANG Jing;ZHANG Xiaohui;ZHANG Hong(School of Medicine,Zhejiang University,Hangzhou 310030,China;Department of Radiology,Ningbo Urology&Nephrology Hospital,Ningbo 315000,China;Department of Nuclear Medicine,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310009,China)

机构地区：[1]浙江大学医学院,浙江杭州310030 [2]宁波市泌尿肾病医院放射科,浙江宁波315000 [3]浙江大学医学院附属第二医院核医学科,浙江杭州310009

出　　处：《中国介入影像与治疗学》2024年第10期602-606,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的观察前列腺癌(PCa)包膜外侵犯(EPE)MRI分型用于预测腹腔镜根治性前列腺切除术(LRP)后切缘阳性的价值。方法回顾性分析114例接受LRP的T3a期PCa MRI数据,根据EPE位置将其分为Ⅰ型(n=14)、Ⅱ型(n=50)及Ⅲ型组(n=50),并根据术后病理所见分为切缘阳性组(n=58)与切缘阴性组(n=56)。比较组间临床、影像学、手术及病理资料;将切缘阳性组与切缘阴性组间差异有统计学意义的指标纳入多因素logistic回归分析,筛选T3a期PCa LRP后切缘阳性的独立影响因素。结果Ⅰ~Ⅲ型组间患者年龄、前列腺特异性抗原(PSA)、肿瘤位置及切缘阳性率差异均有统计学意义(P均<0.05)。Ⅲ型组切缘阳性率为68.00%(34/50),高于Ⅰ型[14.29%(2/14)]及Ⅱ型组[44.00%(22/50)](P均<0.05)。切缘阳性组与切缘阴性组间PSA、穿刺阳性针数占比及EPE MRI分型差异均有统计学意义(P均<0.05),其中,穿刺阳性针数占比及EPE MRI分型均为T3a期PCa LRP后切缘阳性的独立影响因素(P均<0.05)。结论MRI PCa-EPE分型可用于预测LRP后切缘阳性;存在MRIⅢ型EPE的PCa更易于LRP后发生切缘阳性。Objective To explore the value of MRI classification of extraprostatic extension(EPE)of prostate cancer(PCa)for predicting positive surgical margin after laparoscopic radical prostatectomy(LRP).Methods Prostate MRI data of 114 PCa patients with stage T3a who underwent LRP were retrospectively analyzed.The patients were divided into typeⅠ(n=14),Ⅱ(n=50)andⅢgroup(n=50)according to EPE location,also into positive margin group(n=58)and negative margin group(n=56)according to postoperative pathology.Then clinical,imaging,surgical and pathological data were compared among typeⅠ—Ⅲgroups and between positive and negative margin groups.The indicators being significantly different between positive and negative margin groups were included in multivariate logistic regression analysis to screen the independent impact factors of positive margin of stage T3a PCa after LRP.Results Significant differences of patients’age,prostate-specific antigen(PSA),tumor location and positive surgical margin rate were found among typeⅠ—Ⅲgroups(all P<0.05).Positive surgical margin rate in typeⅢgroup was 68.00%(34/50),higher than that in typeⅠ(14.29%[2/14])andⅡgroup(44.00%[22/50])(both P<0.05).Meanwhile,significant differences of PSA,the proportion of positive puncture needles and EPE MRI classification of PCa were found between positive and negative margin groups(all P<0.05),among which the proportion of positive puncture needles and EPE MRI classification of PCa were both independent impact factors of positive margin of stage T3a PCa after LRP(both P<0.05).Conclusion MRI classification of PCa-EPE could be used to predict positive surgical margin after LRP.Positive surgical margin after LRP tended to occur in PCa with MRI typeⅢEPE.

关 键 词：前列腺肿瘤 前列腺切除术 磁共振成像 

分 类 号：R737.25[医药卫生—肿瘤] R445.2[医药卫生—临床医学]