Prostate cancer is the second most common cancer in men, with 1.1 million new cases worldwide reported by the World Health Organization in one recent year. Transrectal ultrasound （TRUS）-guided biopsy has been used f...Prostate cancer is the second most common cancer in men, with 1.1 million new cases worldwide reported by the World Health Organization in one recent year. Transrectal ultrasound （TRUS）-guided biopsy has been used for the diagnosis of prostate cancer for over 2 decades, but the technique is usually blind to cancer location. Moreover, the false negative rate of TRUS biopsy has been reported to be as high as 47%. Multiparametric magnetic resonance imaging （mp-MRI） includes T1- and T2-weighted imaging as well as dynamic contrast-enhanced （DCE） and diffusion-weighted imaging （DWI）. mp-MRI is a major advance in the imaging of prostate cancer, enabling targeted biopsy of suspicious lesions. Evolving targeted biopsy techniquesmincluding direct in-bore biopsy, cognitive fusion and software-based MRI-ultrasound （MRI-US） fusion--have led to a several-fold improvement in cancer detection compared to the earlier method. Importantly, the detection of clinically significant cancers has been greatly facilitated by targeting, compared to systematic biopsy alone. Targeted biopsy via MRI-US fusion may dramatically alter the way prostate cancer is diagnosed and managed.展开更多
目的系统性比较分析靶向融合穿刺与系统性穿刺在前列腺癌临床诊断方面的差异。方法人工通过计算机检索Pub Med、Medline、中国知网、中国生物医学文献数据库、万方数据库中关于靶向融合穿刺与系统性穿刺在前列腺癌检出率方面的对比研究...目的系统性比较分析靶向融合穿刺与系统性穿刺在前列腺癌临床诊断方面的差异。方法人工通过计算机检索Pub Med、Medline、中国知网、中国生物医学文献数据库、万方数据库中关于靶向融合穿刺与系统性穿刺在前列腺癌检出率方面的对比研究。检索时间从建库开始至2016年10月，分别由2名评价员制定纳入、排除标准，同时对纳入文献进行资料提取及质量评价。采用RevMan5.3软件对两种穿刺方式对前列腺癌检出率进行荟萃（Meta）分析。结果共纳入15篇临床研究，相关患者5 337例，其中靶向融合穿刺2 667例，系统性穿刺2 670例。Meta分析结果显示靶向融合穿刺的前列腺癌总体检出率显著高于系统性穿刺（OR＝1.16，95% CI 1.04～1.30，P＝0.007）。我们以Gleason评分7分为界，分别对两种穿刺方式对不同危险等级的前列腺癌检出率进行比较研究。结果显示在Gleason≥7分的中高危前列腺癌中，靶向融合穿刺较系统性穿刺在检出率方面具有显著优势（OR＝1.37，95% CI 1.19～1.58，P〈0.05）。而在Gleason评分〈7的低危前列腺癌中，靶向融合穿刺较系统性穿刺的前列腺癌检出率表现较差（OR＝0.76，95% CI 0.65～0.89，P〈0.05）。结论靶向融合穿刺在前列腺癌总体检出率及Gleason≥7分的中高危前列腺癌检出率方面显著优于系统性穿刺，而在Gleason〈7分的低危前列腺癌中系统性穿刺则表现较好。展开更多
文摘Prostate cancer is the second most common cancer in men, with 1.1 million new cases worldwide reported by the World Health Organization in one recent year. Transrectal ultrasound （TRUS）-guided biopsy has been used for the diagnosis of prostate cancer for over 2 decades, but the technique is usually blind to cancer location. Moreover, the false negative rate of TRUS biopsy has been reported to be as high as 47%. Multiparametric magnetic resonance imaging （mp-MRI） includes T1- and T2-weighted imaging as well as dynamic contrast-enhanced （DCE） and diffusion-weighted imaging （DWI）. mp-MRI is a major advance in the imaging of prostate cancer, enabling targeted biopsy of suspicious lesions. Evolving targeted biopsy techniquesmincluding direct in-bore biopsy, cognitive fusion and software-based MRI-ultrasound （MRI-US） fusion--have led to a several-fold improvement in cancer detection compared to the earlier method. Importantly, the detection of clinically significant cancers has been greatly facilitated by targeting, compared to systematic biopsy alone. Targeted biopsy via MRI-US fusion may dramatically alter the way prostate cancer is diagnosed and managed.
文摘目的系统性比较分析靶向融合穿刺与系统性穿刺在前列腺癌临床诊断方面的差异。方法人工通过计算机检索Pub Med、Medline、中国知网、中国生物医学文献数据库、万方数据库中关于靶向融合穿刺与系统性穿刺在前列腺癌检出率方面的对比研究。检索时间从建库开始至2016年10月，分别由2名评价员制定纳入、排除标准，同时对纳入文献进行资料提取及质量评价。采用RevMan5.3软件对两种穿刺方式对前列腺癌检出率进行荟萃（Meta）分析。结果共纳入15篇临床研究，相关患者5 337例，其中靶向融合穿刺2 667例，系统性穿刺2 670例。Meta分析结果显示靶向融合穿刺的前列腺癌总体检出率显著高于系统性穿刺（OR＝1.16，95% CI 1.04～1.30，P＝0.007）。我们以Gleason评分7分为界，分别对两种穿刺方式对不同危险等级的前列腺癌检出率进行比较研究。结果显示在Gleason≥7分的中高危前列腺癌中，靶向融合穿刺较系统性穿刺在检出率方面具有显著优势（OR＝1.37，95% CI 1.19～1.58，P〈0.05）。而在Gleason评分〈7的低危前列腺癌中，靶向融合穿刺较系统性穿刺的前列腺癌检出率表现较差（OR＝0.76，95% CI 0.65～0.89，P〈0.05）。结论靶向融合穿刺在前列腺癌总体检出率及Gleason≥7分的中高危前列腺癌检出率方面显著优于系统性穿刺，而在Gleason〈7分的低危前列腺癌中系统性穿刺则表现较好。
