| 引用本文： |
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陈之灏,孙可宁,何奕俊,等.认知靶向融合穿刺病理联合mpMRI参数预测前列腺癌长期生化复发的随访研究[J].同济大学学报（医学版）,2022,43(3):338-343. [点击复制]
- CHEN Zhihao,SUN Kening,HE Yijun,et al.Predicting long-term biochemical recurrence of prostate cancer based on cognitive fusion targeted biopsy pathology and mpMRI parameters[J].同济大学学报（医学版）,2022,43(3):338-343. [点击复制]
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| 摘要: |
| 目的确定生化复发相关的前列腺癌根治术前特征，寻找前列腺癌远期生化复发风险预测方法。方法回 顾性分析2009年—2018年于复旦大学附属华东医院接受前列腺癌根治手术的210例患者临床资料，63例患者出现术后生化复发，作为生化复发组，其余147例未出现生化复发的患者作为对照组，中位随访时间71个月。比较2组患者的一般情况、磁共振结果及病理学特征。采用Cox回归模型分析生化复发的危险因素以及构建模型，使用Kaplan-Meier法分析该模型在术前预测前列腺癌患者生化复发的诊断效能。结果生化复发组MRI病灶长径[（16±8） mm vs （12±5） mm]、MRI下包膜外侵犯率（42.9% vs 20.4%）、MRI下精囊侵犯率（23.8% vs 5.4%）、PI-RADS评分、活检国际泌尿外科病理协会(International Society of Urological Pathology, ISUP)分级分组均高于对照组（P<0.05），Cox多因素分析筛选出MRI病灶长径、MRI下精囊侵犯、ISUP分级分组为前列腺癌患者生化复发的独立危险因素。基于融合穿刺的术前特征包括磁共振最大病灶长径>23 mm、术前靶向穿刺ISUP分级分组≥3分和磁共振精囊侵犯，建立风险预测分层模型，精准预测了前列腺癌根治术后生化复发（AUC=0.692,P<0.001），对于传统的d’Amico风险评分在同一队列中检验有更大的曲线下面积。结论生化复发与术前MRI病灶长径、包膜外侵犯、精囊侵犯、PI-RADS评分和ISUP分级分组有关，认知靶向融合穿刺病理联合mpMRI参数能够用于评估前列腺癌患者术后长期生化复发风险，为前列腺癌治疗提供参考。 |
| 关键词: 前列腺癌 前列腺癌根治术 认知融合靶向穿刺 多参数磁共振 生化复发 |
| DOI：10.12289/j.issn.1008-0392.21527 |
| 投稿时间：2021-12-14 |
| 基金项目:上海市科学技术委员会西医引导项目（18411960700） |
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| Predicting long-term biochemical recurrence of prostate cancer based on cognitive fusion targeted biopsy pathology and mpMRI parameters |
| CHEN Zhihao,SUN Kening,HE Yijun,WU Xin,ZHANG Jinxiong,WU Jianhong,SHENG Lu |
| (Department of Urology, Huadong Hospital Affillated to Fudan University, Shanghai 200040, China) |
| Abstract: |
| ObjectiveTo predict long-term biochemical recurrence（BCR） of prostate cancer based on cognitive fusion biopsy characteristics and mpMRI parameters. MethodsThe clinical data of 210 patients with prostate cancer admitted from 2009 to 2018 were respectively analyzed. The median follow-up was 71 months. there were 63 patients with biochemical recurrence（BCR group）, and 147 patients without BCR（control group）. The risk factors of BCR were analyzed by multivariate Cox regression; a risk prediction model was established based on risk factors and the efficacy of the model in predicting BCR of prostate cancer patients before surgery was evaluated. ResultsThe length of maximum lesion on MRI[（16±8） mm vs （12±5） mm], the rate of extracapsular invasion on MRI（42.9% vs 20.4%）, the rate of seminal vesicle invasion on MRI（23.8% vs 5.4%）, PI-RADS score, and biopsy ISUP grade group in BCR group were significantly higher than those in the control group（all P<0.05）. Cox multivariate analysis showed that MRI lesion length, seminal vesicle invasion and ISUP grade group were independent risk factors for BCR of prostate cancer. Based on the preoperative characteristics of fusion biopsy, including the length of maximum MRI lesion>23 mm, preoperative targeted biopsy ISUP grade group≥3, and MRI seminal vesicle invasion, a stratified risk prediction model was established. The area under the ROC curve（AUC） of the model for predicting BCR of prostate cancer was 0.692（P<0.001）, which was higher than that of traditional D’Amico risk score. ConclusionBiochemical recurrence of prostate cancer after radical surgery is associated with preoperative MRI lesion length, extracapsular invasion, seminal vesicle invasion, PI-RADS score and ISUP grade group. Cognitive fusion targeted biopsy pathology combined with mpMRI parameters can be used to predict the risk of long-term biochemical recurrence in prostate cancer patients after surgery. |
| Key words: prostate cancer radical prostatectomy cognitive fusion targeted biopsy multi-parametric magnetic resonance image biochemical recurrence |
