Comparison of cognitive fusion targeted puncture and systematic puncture in the diagnosis of prostate cancer with PI-RADS score of 5
Ma Xuezhong1, Wang Xu1, Wei Yunfei1, Chao Lü2, Wang Yaohui3, Xu Guojiang1, Xu Yan1,*
1Department of Urology,Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China; 2Department of Radiology,Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China; 3Department of Pathology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China
摘要目的：探讨认知融合靶向穿刺和系统穿刺在多参数磁共振(mp-MRI)PI-RADS(V2)评分5分前列腺活检患者中的临床诊断价值。方法：纳入我院泌尿外科2021年1~12月期间收治的疑似PCa患者80例,根据穿刺方式分为认知融合靶向穿刺组14例和认知融合靶向穿刺联合系统穿刺组66例。观察术后并发症发生情况,根据病理结果,分析不同穿刺方式两组患者的PCa诊断阳性率。结果： 80例患者中,87.5%(70/80)的患者最终经病理学诊断为PCa。认知融合靶向穿刺组和认知融合靶向穿刺联合系统穿刺组的PCa诊断阳性率分别为92.86%(13/14)和86.36%(57/66),两组患者PCa诊断阳性率不存在统计学差异(P>0.05)。两组肉眼血尿的发生率(15.07% vs 17.92%)、尿潴留发生率(6.85% vs 7.55%)、术后感染发生率(4.11% vs 4.72%),差异无统计学意义(P>0.05)。两组患者在不同年龄、tPSA、fPSA/tPSA水平PCa诊断阳性率无明显差异(P>0.05);当患者年龄>60岁、tPSA>10μg/L 、fPSA/tPSA<0.15时,两组患者PCa阳性率均出现相应的升高。结论：认知融合靶向穿刺在MRI高度怀疑前列腺癌(PI-RADS评分5分)的患者中能以更少的针数达到与靶向穿刺联合系统穿刺相当的PCa检出率,并且有助于减少活检不良事件的潜在发生。
Abstract： Objective： To investigate the clinical diagnostic value of cognitive fusion targeted puncture and systematic puncture in prostate biopsy patients with multiparametric magnetic resonance （mp-MRI） PI-RADS（V2） score of 5 points. Methods： A total of 80 patients with suspected prostate cancer （PCa） who were admitted to the Department of Urology in our hospital from January to December 2021 were included. According to the puncture method, they were divided into a cognitive fusion targeted puncture group （14 cases） and a cognitive fusion targeted puncture combined with systematic puncture group （66 cases）. The incidence of postoperative complications was observed, and the positive rate of PCa diagnosis in the two groups of patients with different puncture methods was analyzed according to the pathological results. Results： Among the 80 patients, 87.5% （70/80） were finally diagnosed as PCa by pathology. The positive rates of PCa diagnosis in the cognitive fusion targeted puncture group and cognitive fusion targeted puncture combined with systematic puncture group were 92.86% （13/14） and 86.36% （57/66）, respectively. There was significant difference in the positive rates of PCa diagnosis between the two groups. No significant difference existed in the incidence of gross hematuria （15.07% vs. 17.92%）, urinary retention （6.85% vs. 7.55%）, and postoperative infection （4.11% vs. 4.72%） between the two groups （P>0.05） . No significant difference was found in the positive rate of PCa diagnosis between the two groups at different ages, tPSA, and fPSA/tPSA levels （P>0.05）. The positive rate all showed a corresponding increase in two groups. Conclusion： Cognitive fusion targeted biopsy can achieve a PCa detection rate comparable to that of targeted biopsy combined with systematic biopsy with fewer needles in patients with highly suspected PCa （PI-RADS score of 5） on MRI, and It is helpful to reduce the potential occurrence of biopsy adverse events.
马雪中, 王旭, 魏云飞, 卢超, 王耀辉, 徐国江, 徐彦. 认知融合靶向穿刺和系统穿刺在PI-RADS评分5分前列腺癌诊断中的比较[J]. 微创泌尿外科杂志, 2022, 11(4): 258-262.
Ma Xuezhong, Wang Xu, Wei Yunfei, Chao Lü, Wang Yaohui, Xu Guojiang, Xu Yan. Comparison of cognitive fusion targeted puncture and systematic puncture in the diagnosis of prostate cancer with PI-RADS score of 5. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2022, 11(4): 258-262.
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