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首页> 外文期刊>Archivio Italiano di Urologia e Andrologia >Detection rate for significant cancer at confirmatory biopsy in men enrolled in Active Surveillance protocol: 20 cores vs 30 cores vs MRI/TRUS fusion prostate biopsy
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Detection rate for significant cancer at confirmatory biopsy in men enrolled in Active Surveillance protocol: 20 cores vs 30 cores vs MRI/TRUS fusion prostate biopsy

机译：参加主动监测方案的确诊活检中男性的重大癌症检出率：20核vs 30核vs MRI / TRUS融合前列腺活检

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Introduction: The detection rate for significant prostate cancer of extended vs saturation vs mMRI/TRUS fusion biopsy was prospectively evaluated in men enrolled in active surveillance (AS) protocol. Mterials and methods: From May 2013 to September 2016 75 men aged 66 years (median) with very low risk PCa were enrolled in an AS protocol and elegible criteria were: life expectancy greater than 10 years, cT1C, PSA below 10 ng/ml, PSA density < 0.20, 2 < unilateral positive biopsy cores, Gleason score (GS) equal to 6, greatest percentage of cancer (GPC) in a core < 50%. All patients underwent 3.0 Tesla pelvic mpMRI before confirmatory transperineal extended (20 cores) or saturation biopsy (SPBx; 30 cores) combined with mpMRI/TRUS fusion targeted biopsy (4 cores) of suspicious lesions (PI-RADS 3-5). Results: 21/75 (28%) patients were reclassified by SPBx based on upgraded GS ≥ 7; mpMRI lesions PI-RADS 4-5 vs PI-RADS 3-5 diagnosed 9/21 (42.8%) vs 16/21 (76.2%) significant PCa with 2 false positives (6.5%). The detection rate for significant PCa was equal to 76.2% (mpMRI/TRUS fusion biopsy) vs 81% (extended) vs 100% (SPBx) (p = 0.001); mpMRI/TRUS targeted biopsy and extended biopsy missed 5/21 (23.8%) and 4/21 (19%) significant PCa which were found by SPBx (p = 0.001) being characterised by the presence of a single positive core of GS ≥ 7 with GPC < 10%. Conclusions: Although mpMRI improve the diagnosis of clinically significant PCa, SPBx is provided of the best detection rate for PCa in men enrolled in AS protocols who underwent confirmatory biopsy.
机译：简介：前瞻性评估了参加主动监护（AS）方案的男性中扩展性，饱和性与mMRI / TRUS融合活检的重要前列腺癌的检出率。材料和方法：从2013年5月至2016年9月，有75位66岁（中位数），PCa风险极低的男性参加了AS方案，可评估的标准是：预期寿命大于10年，cT1C，PSA低于10 ng / ml， PSA密度<0.20，2 <单侧阳性活检核心，格里森评分（GS）等于6，最大癌症百分比（GPC）在核心中<50％。所有患者均接受3.0特斯拉骨盆mpMRI检查，然后进行可确认的会阴扩展性（20核）或饱和活检（SPBx; 30核），并结合可疑病变（PI-RADS 3-5）的mpMRI / TRUS融合靶向活检（4核）。结果：基于升级版GS≥7，有21/75（28％）的患者通过SPBx重新分类; mpMRI病变PI-RADS 4-5与PI-RADS 3-5诊断为9/21（42.8％）vs 16/21（76.2％）的重要PCa，假阳性为2（6.5％）。显着PCa的检出率等于76.2％（mpMRI / TRUS融合活检）vs 81％（扩展）vs 100％（SPBx）（p = 0.001）; mpMRI / TRUS靶向活检和延长活检错过了5/21（23.8％）和4/21（19％）的重要PCa，而SPBx（p = 0.001）发现这些PCa的特征是存在单个GS≥7的阳性核心GPC <10％。结论：尽管mpMRI改善了临床上重要的PCa的诊断，但SPBx被提供为接受AS方案确认性活检的男性中PCa的最佳检出率。

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