Negatif multiparametrik prostat manyetik rezonans görüntülemesi olan hastalarda prostat kanseri belirteçleri

Year 2024, Volume: 49 Issue: 2, 479 - 488, 30.06.2024

Coşkun Bostancı Kazım Erdem

https://doi.org/10.17826/cumj.1446498

Abstract

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.

Keywords

Prostat biyopsisi, prostat hacmi, prostat spesifik antijen yoğunluğu, prostat kanseri

Predictive parameters of prostate carcinoma in negative multiparametric prostate magnetic resonance imaging patients

Abstract

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.

Keywords

prostate biopsy, prostate carcinoma, prostate specific antgen density, prostate volume

Ethical Statement

ALREADY LOADED

Supporting Institution

N/A

Thanks

N/A

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