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Predictive parameters of prostate carcinoma in negative multiparametric prostate magnetic resonance imaging patients Skip to content Yıl 2024, Cilt: 49 Sayı: 2, 479 – 488, 30.06.2024
Coşkun Bostancı , Kazım Erdem
https://doi.org/10.17826/cumj.1446498
Öz Amaç: Biyopsi öncesi negatif multiparametrik prostat manyetik rezonans görüntülemesi (mpMRI) olan ve prostat spesifik antijen (PSA) değeri 4-10 ng/ml olan hastalarda prostat kanseri ve klinik olarak anlamlı prostat kanserinin belirleyicilerini değerlendirilmesi amaçlanmıştır.. Gereç ve Yöntem: Çalışma, biyopsi öncesi mpMRI negatif olan 227 hastanın verilerini analiz edildi. Bu 227 hastanın patoloji raporları incelenerek hangi oranda prostat kanseri ve klinik anlamlı prostat kanseri saptandığı hesaplandı. Tek değişkenli ve çift değişkenli analizlerle hangi faktörlerin (yaş, PSA düzeyi, prostat hacmi, PSA yoğunluğu, serbest /total PSA oranı, primer biyopsi ile önceki negatif biyopsi ve parmakla rektal muayene sonuçları) prostat kanseri ve klinik anlamlı prostat kanseri için risk oluşturduğu ölçüldü. Bulgular: Prostat kanser oranı ve klinik olarak anlamlı prostat kanseri tespit oranı sırasıyla %18,9 ve %8,8 idi. Çok değişkenli analiz, prostat kanseri için PSA yoğunluğu ve şüpheli dijital rektal muayene sonuçlarının, klinik anlamlı prostat kanseri için ise yaş ve şüpheli dijital rektal muayene sonuçlarının risk olduğunu ortaya çıkardı. Hem prostat kanseri hem de klinik anlamlı prostat kanseri için PSA yoğunluğu ve prostat hacmi en yüksek AUC değerine sahipti. Klinik anlamlı prostat kanseri için PSA yoğunluğu eşik değeri> 0.12 ng/ml/cc iken prostat hacmi eşik değeri ≤ 46 cc olarak ölçüldü. Sonuç: Çalışmanın bulgularına göre bu grup hastalarda biyopsi kararı verebilmek için PSA yoğunluğu (> 0,12 ng/ml/ml) ve prostat hacminin (≤ 46 cc) dikkatle değerlendirilmesi önerilebilir. Bu bulguların daha yüksek hacimli çalışmalarla desteklenmesine ihtiyaç vardır.
Anahtar Kelimeler Prostat biyopsisi, prostat hacmi, prostat spesifik antijen yoğunluğu, prostat kanseri
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J Am Board Fam Pract.2003;16:95-101
Predictive parameters of prostate carcinoma in negative multiparametric prostate magnetic resonance imaging patients Yıl 2024, Cilt: 49 Sayı: 2, 479 – 488, 30.06.2024
Coşkun Bostancı , Kazım Erdem
https://doi.org/10.17826/cumj.1446498
Öz Purpose: The aim of this study was to evaluate the predictors of prostate cancer and clinically significant prostate cancer in prostate-specific antigen grey zone patients with pre-biopsy negative multiparametric prostate magnetic resonance imaging. Materials and Methods: The study analyzed data from 227 patients with negative pre-biopsy multiparametric prostate magnetic resonance imaging results. The detection rates of prostate cancer and clinically significant prostate cancer were calculated, and simple and multiple logistic regression were used to evaluate the predictors of prostate cancer and clinically significant prostate cancer. Results: The overall prostate cancer rate was 18.9% and the clinically significant prostate cancer detection rate was 8.8%. Multivariate analysis revealed that prostate-specific antigen density and abnormal digital rectal examination were the independent predictive factors for prostate carcinoma, while age and abnormal digital rectal examination were the independent predictive factors for clinically significant prostate carcinoma. Prostate-specific antigen density with the cutoff value of > 0,12 ng/ml/cc had the highest area under curve values for clinically significant prostate carcinoma followed by prostate volume with a cutoff value of ≤ 46 cc. Conclusion: Based on the findings of the study, the cutoff value of prostate-specific antigen density of > 0,12 ng/ml/cc and prostate volume ≤ 46 cc might be considered for biopsy decision in grey zone patients regardless of multiparametric prostate magnetic resonance results. However, further studies with larger cohorts are required to validate these recommendations.
Anahtar Kelimeler prostate biopsy, prostate carcinoma, prostate specific antgen density, prostate volume
Etik Beyan ALREADY LOADED
Destekleyen Kurum N/A
Teşekkür N/A
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Eur Urol. 2020;77:78-94. Barentsz JO, Weinreb JC, Verma S, Thoeny HC, Tempany CM, Shtern F et al. Synopsis of the PI-RADS v2 guidelines for multiparametric prostate magnetic resonance imaging and recommendations for use. Eur Urol. 2016;69:41-9. Wang RS, Kim EH, Vetter JM, Fowler KJ, Shetty AS, Mintz AJ et al. Determination of the role of negative magnetic resonance imaging of the prostate in clinical practice: is biopsy still necessary? Urology. 2017;102:190-7. Lu AJ, Syed JS, Nguyen KA, Nawaf CB, Rosoff J, Spektor M et al. Negative multiparametric magnetic resonance imaging of the prostate predicts absence of clinically significant prostate cancer on 12-core template prostate biopsy. Urology. 2017;105:118-22. Schoots IG, Padhani AR, Rouvière O, Barentsz JO, Richenberg J. Analysis of magnetic resonance imaging-directed biopsy strategies for changing the paradigm of prostate cancer diagnosis. Eur Urol Oncol. 2020;3:32-41. Kasivisvanathan V, Rannikko AS, Borghi M, Panebianco V, Mynderse LA, Vaarala MH et al; PRECISION study group collaborators. MRI-targeted or standard biopsy for prostate-cancer diagnosis. N Engl J Med. 2018;378:1767-77. Coogan CL, Latchamsetty KC, Greenfield J, Corman JM, Lynch B, Porter CR. Increasing the number of biopsy cores improves the concordance of biopsy gleason score to prostatectomy gleason score. BJU Int. 2005;96:324-27. Haack M, Miksch V, Tian Z, Duwe G, Thomas A, Borkowetz A et al. Negative multiparametric magnetic resonance imaging for prostate cancer: further outcome and consequences. World J Urol. 2022;40:2947-54. Panebianco V, Barchetti G, Simone G, Del Monte M, Ciardi A, Grompone MD et al. Negative multiparametric magnetic resonance imaging for prostate cancer: what's next? Eur Urol. 2018;74:48-54. Liang L, Qi F, Cheng Y, Zhang L, Cao D, Cheng G, Hua L. Analysis of risk factors for determining the need for prostate biopsy in patients with negative MRI. Sci Rep. 2021;11:6048. 14-Schoots IG, Padhani AR. Risk-adapted biopsy decision based on prostate magnetic resonance imaging and prostate-specific antigen density for enhanced biopsy avoidance in first prostate cancer diagnostic evaluation. BJU Int. 2021;127:175-8. Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA; Grading committee. the 2014 international society of urological pathology (ISUP) consensus conference on gleason grading of prostatic carcinoma: definition of grading patterns and proposal for a new grading system. Am J Surg Pathol. 2016;40:244-52. Johnson DC, Raman SS, Mirak SA, Kwan L, Bajgiran AM, Hsu W et al. Detection of individual prostate cancer foci via multiparametric magnetic resonance imaging. Eur Urol. 2019;75:712-20. Stabile A, Dell'Oglio P, De Cobelli F, Esposito A, Gandaglia G, Fossati N et al. Association between prostate imaging reporting and data system (PI-RADS) score for the index lesion and multifocal, clinically significant prostate cancer. Eur Urol Oncol. 2018;1:29-36. Marks LS. Some prostate cancers are invisible to magnetic resonance imaging! BJU Int. 2016;118:492-3. Nordström T, Akre O, Aly M, Grönberg H, Eklund M. Prostate-specific antigen (PSA) density in the diagnostic algorithm of prostate cancer. Prostate Cancer Prostatic Dis. 2018;21:57-63. Pagniez MA, Kasivisvanathan V, Puech P, Drumez E, Villers A, Olivier J. Predictive factors of missed clinically significant prostate cancers in men with negative magnetic resonance imaging: a systematic review and meta-analysis. J Urol. 2020;204:24-32. Buisset J, Norris JM, Puech P, Leroy X, Ramdane N, Drumez E et al. Negative prebiopsy magnetic resonance imaging and risk of significant prostate cancer: baseline and long-term follow up results. J Urol. 2021;205:725-31. Oishi M, Shin T, Ohe C, Nassiri N, Palmer SL, Aron M et al. Which patients with negative magnetic resonance imaging can safely avoid biopsy for prostate cancer? J Urol. 2019;201:268-76. Artiles Medina A, Rodríguez-Patrón Rodríguez R, Ruiz Hernández M, Mata Alcaraz M, García Barreras S, Fernández Conejo G et al. Identifying risk factors for mri-invisible prostate cancer in patients undergoing transperineal saturation biopsy. Res Rep Urol. 2021;13:723-31. Moolupuri A, Camacho J, de Riese WT. Association between prostate size and the incidence of prostate cancer: a meta-analysis and review for urologists and clinicians. Int Urol Nephrol. 2021;53:1955-61. Gosselaar C, Roobol MJ, Roemeling S, de Vries SH, Cruijsen-Koeter Iv, van der Kwast TH et al. European randomized study of screening for prostate cancer (ERSPC). Screening for prostate cancer without digital rectal examination and transrectal ultrasound: results after four years in the European Randomized Study of Screening for Prostate Cancer (ERSPC), Rotterdam. Prostate. 2006;66:625-31. Catalona WJ, Smith DS, Ratliff TL, Dodds KM, Coplen DE, Yuan JJ et al: Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med. 1991;324:1156-61. 27-Nam RK, Kattan MW, Chin JL, Trachtenberg J, Singal R, Rendon R et al: Prospective multi-institutional study evaluating the performance of prostate cancer risk calculators. J Clin Oncol. 2011;29:2959-64. Djavan B, Zlotta A, Kratzik C et al. PSA, PSA density, PSA density of transition zone, free/total PSA ratio and PSA velocity for early detection of prostate cancer in men with serum PSA 2.5 to 4.0 ng/ mL. Urology. 1999;54:517-22. Mistry K and Cable G: Meta-analysis of prostate-specific antigen and digital rectal examination as screening tests for prostate carcinoma. J Am Board Fam Pract.2003;16:95-101 Toplam 29 adet kaynakça vardır.
Ayrıntılar Birincil Dil İngilizce Konular Üroloji Bölüm Araştırma Yazarlar Coşkun Bostancı karabük sağlık müdürlüğü karabük eğitim ve araştırma hastanesi 0000-0002-4493-8653 Türkiye
Kazım Erdem KARABÜK EĞİTİM VE ARAŞTIRMA HASTANESİ 0009-0006-7455-3515 Türkiye
Yayımlanma Tarihi 30 Haziran 2024 Gönderilme Tarihi 3 Mart 2024 Kabul Tarihi 4 Haziran 2024 Yayımlandığı Sayı Yıl 2024 Cilt: 49 Sayı: 2
Kaynak Göster MLA Bostancı, Coşkun ve Kazım Erdem. “Predictive Parameters of Prostate Carcinoma in Negative Multiparametric Prostate Magnetic Resonance Imaging Patients”. Cukurova Medical Journal, c. 49, sy. 2, 2024, ss. 479-88, doi:10.17826/cumj.1446498.
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