Comparison of the incidence of clinically significant prostate cancer in patients with isolated peripheral versus transitional zone PIRADS 3 lesions.

IF 0.8 Q4 UROLOGY & NEPHROLOGY Urologia Journal Pub Date : 2024-09-30 DOI:10.1177/03915603241286064
Kamil Malshy, Anna Ochsner, Rebecca Ortiz, Benjamin Ahn, Richard Glebocki, Matthew Liu, Borivoj Golijanin, Samuel Eaton, Gyan Pareek, Elias Hyams, Dragan Golijanin, Sari Khaleel
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Abstract

Introduction: We sought to investigate the association between isolated PIRADS 3 lesions of the transitional zone (TZ) versus the peripheral zone (PZ) and the incidence of clinically significant prostate cancer (csPCa) on systematic and targeted prostate biopsy (SB, TB).

Methods: We retrospectively reviewed our tertiary institutional database of patients who underwent mpMRI-fusion followed by TB + SB between 2016 and 2021. We compared the incidence of csPCa (Gleason Grade Group ⩾ 2) in patients with solitary TZ-only PIRADS 3 and PZ-only PIRADS 3 on SB and TB. We excluded patients with (1)known PCa, (2)PIRADS 4-5 and/or (3)lesions in both TZ and PZ. T-tests, Chi-square tests, were conducted to compare between the groups.

Results: Of 1913 patients, we identified 110 with PZ-only and 38 with TZ-only PIRADS 3 lesions. 73 patients in PZ-only and 19 in TZ-only met inclusion criteria. No statistically significant differences were observed between PZ and TZ groups in terms of age, median prostate-specific antigen (PSA), prostate volume, median PSA-density, or median number of targeted cores obtained, all with p > 0.05.On SB, the incidence of csPCA was higher in patients with PZ rather than TZ PIRADS-3 lesions (10/73 vs 1/19, p = 0.28). Similarly, csPCA was more common in TB of PZ versus TZ PIRADS 3 lesions (7/73 vs 0/19, p = 0.33). Based on these results, the positive predictive values of PIRADS3 as a marker of csPCA were 5.3% and 0% for TZ lesions on SB versus TB, respectively, compared to 17.7% and 9.6% in the PZ.

Conclusions: PIRADS 3 lesions are rarely associated with csPCA on SB and TB, particularly when located in the TZ, which is an important factor to consider when deciding on a biopsy in patients with isolated TZ lesions.

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比较孤立外周与过渡区 PIRADS 3 病变患者中具有临床意义的前列腺癌发病率。
前言:我们试图研究过渡区(TZ)与外周区(PZ)孤立的 PIRADS 3 病变与系统性和靶向性前列腺活检(SB、TB)中有临床意义的前列腺癌(csPCa)发生率之间的关联:我们回顾性地查看了2016年至2021年期间接受mpMRI融合后TB+SB检查的患者的三级机构数据库。我们比较了SB和TB上单发TZ-纯PIRADS 3和PZ-纯PIRADS 3患者的csPCa(Gleason分级组别⩾ 2)发生率。我们排除了(1)已知 PCa、(2)PIRADS 4-5 和/或(3)TZ 和 PZ 均有病变的患者。通过 T 检验和卡方检验对各组进行比较:在 1913 例患者中,我们发现 110 例仅有 PZ 病变,38 例仅有 TZ PIRADS 3 病变。符合纳入标准的纯 PZ 患者有 73 人,纯 TZ 患者有 19 人。PZ 组和 TZ 组在年龄、前列腺特异性抗原 (PSA) 中位数、前列腺体积、PSA 密度中位数或获得的靶核数中位数方面均无统计学差异,P 均大于 0.05。同样,在 PZ 而非 TZ PIRADS-3 病变的肺结核患者中,csPCA 的发生率更高(7/73 vs 0/19,p = 0.33)。基于这些结果,PIRADS3 作为 csPCA 标记的阳性预测值在 SB 和 TB 的 TZ 病变中分别为 5.3% 和 0%,而在 PZ 中分别为 17.7% 和 9.6%:结论:PIRADS 3病变很少与SB和TB上的csPCA相关,尤其是位于TZ的病变,这是对孤立的TZ病变患者决定进行活检时需要考虑的一个重要因素。
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来源期刊
Urologia Journal
Urologia Journal UROLOGY & NEPHROLOGY-
CiteScore
0.60
自引率
12.50%
发文量
66
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