Sinh thiết nhắm mục tiêu bằng MRI so với sinh thiết chuẩn bằng siêu âm qua trực tràng: một đánh giá hệ thống và phân tích tổng hợp các thử nghiệm lâm sàng ngẫu nhiên

Springer Science and Business Media LLC - Tập 45 - Trang 3283-3292 - 2020
Xu Hu1, Zhi-Qiang Yang1, Yan-Xiang Shao1, Wei-Chao Dou1, San-Chao Xiong1, Wei-Xiao Yang1, Xiang Li2
1West China School of Medicine/West China Hospital, Sichuan University, Chengdu, People’s Republic of China
2Department of Urology, West China Medical School, West China Hospital, Sichuan University, Chengdu, People’s Republic of China

Tóm tắt

Đối với nam giới có nghi ngờ mắc ung thư tuyến tiền liệt (PCa), sinh thiết dưới hướng dẫn siêu âm qua trực tràng (TRUS-Bx) được khuyến nghị. Chụp cộng hưởng từ đa thông số (mp-MRI) có thể hữu ích hơn để lựa chọn chính xác hơn những bệnh nhân có triệu chứng lâm sàng của PCa và đủ điều kiện làm sinh thiết, và tránh sinh thiết nếu kết quả âm tính. Trong nghiên cứu hiện tại, chúng tôi đã so sánh sinh thiết nhắm mục tiêu bằng MRI (MRI-TBx) với TRUS-Bx. Chúng tôi đã tìm kiếm trong các cơ sở dữ liệu trực tuyến sau: PubMed, Embase, và Thư viện Cochrane, và tìm kiếm được cập nhật đến tháng 3 năm 2019. Cuối cùng, tổng cộng có 8 thử nghiệm lâm sàng ngẫu nhiên (RCT) với 2593 bệnh nhân được đưa vào phân tích cuối cùng. MRI-TBx và TRUS-Bx không khác biệt đáng kể về tổng thể PCa (RR = 1.30; 95% CI 0.98–1.72; P = 0.067), PCa có ý nghĩa lâm sàng (RR = 1.35; 95% CI 0.98–1.86; P = 0.065), và PCa không có ý nghĩa lâm sàng (RR = 0.76; 95% CI 0.40–1.46; P = 0.416). Trong khi ở những bệnh nhân có sinh thiết ban đầu, MRI-TBx có tỷ lệ phát hiện tổng thể PCa cao hơn đáng kể (RR = 1.40; 95% CI 1.01–1.94; P = 0.045). Trong nghiên cứu hiện tại, chúng tôi nhận thấy rằng MRI-TBx có lợi cho việc phát hiện tổng thể và PCa có ý nghĩa lâm sàng so với TRUS-Bx ở những bệnh nhân nghi ngờ mắc PCa. Hơn nữa, ở những bệnh nhân có sinh thiết ban đầu, MRI-TBx có tỷ lệ phát hiện tổng thể PCa cao hơn đáng kể và tỷ lệ phát hiện có thể cao hơn về PCa có ý nghĩa lâm sàng. Trong khi đó, đối với những bệnh nhân có sinh thiết âm tính trước đó, chúng tôi không phát hiện sự khác biệt đáng kể về tổng thể và PCa có ý nghĩa lâm sàng giữa hai nhóm. Cần có thêm các RCT lớn và đa trung tâm.

Từ khóa

#Sinh thiết nhắm mục tiêu bằng MRI #sinh thiết TRUS #ung thư tuyến tiền liệt #phân tích tổng hợp #thử nghiệm lâm sàng ngẫu nhiên.

Tài liệu tham khảo

Siegel RL, Miller KD, Jemal A (2019) Cancer statistics, 2019. CA: a cancer journal for clinicians 69 (1):7-34. https://doi.org/10.3322/caac.21551. Ahmed HU, El-Shater Bosaily A, Brown LC, Gabe R, Kaplan R, Parmar MK, Collaco-Moraes Y, Ward K, Hindley RG, Freeman A, Kirkham AP, Oldroyd R, Parker C, Emberton M (2017) Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet (London, England) 389 (10071):815-822. https://doi.org/10.1016/s0140-6736(16)32401-1. Kasivisvanathan V, Rannikko AS, Borghi M, Panebianco V, Mynderse LA, Vaarala MH, Briganti A, Budaus L, Hellawell G, Hindley RG, Roobol MJ, Eggener S, Ghei M, Villers A, Bladou F, Villeirs GM, Virdi J, Boxler S, Robert G, Singh PB, Venderink W, Hadaschik BA, Ruffion A, Hu JC, Margolis D, Crouzet S, Klotz L, Taneja SS, Pinto P, Gill I, Allen C, Giganti F, Freeman A, Morris S, Punwani S, Williams NR, Brew-Graves C, Deeks J, Takwoingi Y, Emberton M, Moore CM (2018) MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis. The New England journal of medicine 378 (19):1767-1777https://doi.org/10.1056/NEJMoa1801993. Abraham NE, Mendhiratta N, Taneja SS (2015) Patterns of repeat prostate biopsy in contemporary clinical practice. The Journal of urology 193 (4):1178-1184. https://doi.org/10.1016/j.juro.2014.10.084. Loeb S, Vellekoop A, Ahmed HU, Catto J, Emberton M, Nam R, Rosario DJ, Scattoni V, Lotan Y (2013) Systematic review of complications of prostate biopsy. European urology 64 (6):876-892. https://doi.org/10.1016/j.eururo.2013.05.049. Futterer JJ, Briganti A, De Visschere P, Emberton M, Giannarini G, Kirkham A, Taneja SS, Thoeny H, Villeirs G, Villers A (2015) Can Clinically Significant Prostate Cancer Be Detected with Multiparametric Magnetic Resonance Imaging? A Systematic Review of the Literature. European urology 68 (6):1045-1053. https://doi.org/10.1016/j.eururo.2015.01.013. Wu LM, Xu JR, Gu HY, Hua J, Chen J, Zhang W, Zhu J, Ye YQ, Hu J (2012) Usefulness of diffusion-weighted magnetic resonance imaging in the diagnosis of prostate cancer. Academic radiology 19 (10):1215-1224. https://doi.org/10.1016/j.acra.2012.05.016. Somford DM, Futterer JJ, Hambrock T, Barentsz JO (2008) Diffusion and perfusion MR imaging of the prostate. Magnetic resonance imaging clinics of North America 16 (4):685-695, ix. https://doi.org/10.1016/j.mric.2008.07.002. Moore CM, Robertson NL, Arsanious N, Middleton T, Villers A, Klotz L, Taneja SS, Emberton M (2013) Image-guided prostate biopsy using magnetic resonance imaging-derived targets: a systematic review. European urology 63 (1):125-140. https://doi.org/10.1016/j.eururo.2012.06.004. van Hove A, Savoie PH, Maurin C, Brunelle S, Gravis G, Salem N, Walz J (2014) Comparison of image-guided targeted biopsies versus systematic randomized biopsies in the detection of prostate cancer: a systematic literature review of well-designed studies. World journal of urology 32 (4):847-858. https://doi.org/10.1007/s00345-014-1332-3. Baco E, Rud E, Eri LM, Moen G, Vlatkovic L, Svindland A, Eggesbo HB, Ukimura O (2016) A Randomized Controlled Trial To Assess and Compare the Outcomes of Two-core Prostate Biopsy Guided by Fused Magnetic Resonance and Transrectal Ultrasound Images and Traditional 12-core Systematic Biopsy. European urology 69 (1):149-156. https://doi.org/10.1016/j.eururo.2015.03.041. Tonttila PP, Lantto J, Paakko E, Piippo U, Kauppila S, Lammentausta E, Ohtonen P, Vaarala MH (2016) Prebiopsy Multiparametric Magnetic Resonance Imaging for Prostate Cancer Diagnosis in Biopsy-naive Men with Suspected Prostate Cancer Based on Elevated Prostate-specific Antigen Values: Results from a Randomized Prospective Blinded Controlled Trial. European urology 69 (3):419-425. Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS medicine 6 (7):e1000097. https://doi.org/10.1371/journal.pmed.1000097. Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clinical research ed) 343:d5928. https://doi.org/10.1136/bmj.d5928. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ (Clinical research ed) 327 (7414):557-560. https://doi.org/10.1136/bmj.327.7414.557. Porpiglia F MMMFCMBEVACSRDFRPRFCDLS (2017) Diagnostic Pathway with Multiparametric Magnetic Resonance Imaging Versus Standard Pathway: results from a Randomized Prospective Study in Biopsy-naive Patients with Suspected Prostate Cancer. European urology 72 (2):282-288. Taverna G, Bozzini G, Grizzi F, Seveso M, Mandressi A, Balzarini L, Mrakic F, Bono P, De Franceco O, Buffi N, Lughezzani G, Lazzeri M, Casale P, Guazzoni GF (2016) Endorectal multiparametric 3-tesla magnetic resonance imaging associated with systematic cognitive biopsies does not increase prostate cancer detection rate: a randomized prospective trial. World journal of urology 34 (6):797-803. https://doi.org/10.1007/s00345-015-1711-4. Panebianco V BFSACAIELPRGMTVGVCC (2015) Multiparametric magnetic resonance imaging vs. standard care in men being evaluated for prostate cancer: a randomized study. Urologic oncology: seminars and original investigations 33 (1). Sciarra A, Panebianco V, Cattarino S, Busetto GM, De Berardinis E, Ciccariello M, Gentile V, Salciccia S (2012) Multiparametric magnetic resonance imaging of the prostate can improve the predictive value of the urinary prostate cancer antigen 3 test in patients with elevated prostate-specific antigen levels and a previous negative biopsy. BJU international 110 (11):1661-1665. https://doi.org/10.1111/j.1464-410X.2012.11146.x. Park BK, Park JW, Park SY, Kim CK, Lee HM, Jeon SS, Seo SI, Jeong BC, Choi HY (2011) Prospective evaluation of 3-T MRI performed before initial transrectal ultrasound-guided prostate biopsy in patients with high prostate-specific antigen and no previous biopsy. American Journal of Roentgenology 197 (5):W876-W881. Ukimura O, Coleman JA, de la Taille A, Emberton M, Epstein JI, Freedland SJ, Giannarini G, Kibel AS, Montironi R, Ploussard G, Roobol MJ, Scattoni V, Jones JS (2013) Contemporary role of systematic prostate biopsies: indications, techniques, and implications for patient care. European urology 63 (2):214-230. https://doi.org/10.1016/j.eururo.2012.09.033. Djavan B, Margreiter M (2007) Biopsy standards for detection of prostate cancer. World journal of urology 25 (1):11-17. https://doi.org/10.1007/s00345-007-0151-1. Schoots IG, Roobol MJ, Nieboer D, Bangma CH, Steyerberg EW, Hunink MG (2015) Magnetic resonance imaging-targeted biopsy may enhance the diagnostic accuracy of significant prostate cancer detection compared to standard transrectal ultrasound-guided biopsy: a systematic review and meta-analysis. European urology 68 (3):438-450. https://doi.org/10.1016/j.eururo.2014.11.037. Ahmed HU, Kirkham A, Arya M, Illing R, Freeman A, Allen C, Emberton M (2009) Is it time to consider a role for MRI before prostate biopsy? Nature reviews Clinical oncology 6 (4):197-206. https://doi.org/10.1038/nrclinonc.2009.18. Siddiqui MM, Rais-Bahrami S, Turkbey B, George AK, Rothwax J, Shakir N, Okoro C, Raskolnikov D, Parnes HL, Linehan WM, Merino MJ, Simon RM, Choyke PL, Wood BJ, Pinto PA (2015) Comparison of MR/ultrasound fusion-guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancer. Jama 313 (4):390-397. https://doi.org/10.1001/jama.2014.17942. Pokorny MR, de Rooij M, Duncan E, Schroder FH, Parkinson R, Barentsz JO, Thompson LC (2014) Prospective study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy versus magnetic resonance (MR) imaging with subsequent MR-guided biopsy in men without previous prostate biopsies. European urology 66 (1):22-29. https://doi.org/10.1016/j.eururo.2014.03.002. Mendhiratta N, Rosenkrantz AB, Meng X, Wysock JS, Fenstermaker M, Huang R, Deng FM, Melamed J, Zhou M, Huang WC, Lepor H, Taneja SS (2015) Magnetic Resonance Imaging-Ultrasound Fusion Targeted Prostate Biopsy in a Consecutive Cohort of Men with No Previous Biopsy: Reduction of Over Detection through Improved Risk Stratification. The Journal of urology 194 (6):1601-1606. https://doi.org/10.1016/j.juro.2015.06.078. Arsov C, Rabenalt R, Blondin D, Quentin M, Hiester A, Godehardt E, Gabbert HE, Becker N, Antoch G, Albers P, Schimmoller L (2015) Prospective randomized trial comparing magnetic resonance imaging (MRI)-guided in-bore biopsy to MRI-ultrasound fusion and transrectal ultrasound-guided prostate biopsy in patients with prior negative biopsies. European urology 68 (4):713-720. https://doi.org/10.1016/j.eururo.2015.06.008. Volkin D, Turkbey B, Hoang AN, Rais-Bahrami S, Yerram N, Walton-Diaz A, Nix JW, Wood BJ, Choyke PL, Pinto PA (2014) Multiparametric magnetic resonance imaging (MRI) and subsequent MRI/ultrasonography fusion-guided biopsy increase the detection of anteriorly located prostate cancers. BJU international 114 (6b):E43-e49. https://doi.org/10.1111/bju.12670. Sonn GA, Chang E, Natarajan S, Margolis DJ, Macairan M, Lieu P, Huang J, Dorey FJ, Reiter RE, Marks LS (2014) Value of targeted prostate biopsy using magnetic resonance-ultrasound fusion in men with prior negative biopsy and elevated prostate-specific antigen. European urology 65 (4):809-815. https://doi.org/10.1016/j.eururo.2013.03.025. Wegelin O, van Melick HHE, Hooft L, Bosch J, Reitsma HB, Barentsz JO, Somford DM (2017) Comparing Three Different Techniques for Magnetic Resonance Imaging-targeted Prostate Biopsies: A Systematic Review of In-bore versus Magnetic Resonance Imaging-transrectal Ultrasound fusion versus Cognitive Registration. Is There a Preferred Technique? European urology 71 (4):517-531. https://doi.org/10.1016/j.eururo.2016.07.041. Tang Y, Liu Z, Tang L, Zhang R, Lu Y, Liang J, Zou Z, Zhou C, Wang Y (2018) Significance of MRI/Transrectal Ultrasound Fusion Three-Dimensional Model-Guided, Targeted Biopsy Based on Transrectal Ultrasound-Guided Systematic Biopsy in Prostate Cancer Detection: A Systematic Review and Meta-Analysis. Urologia internationalis 100 (1):57-65. https://doi.org/10.1159/000484144. Quentin M, Blondin D, Arsov C, Schimmoller L, Hiester A, Godehardt E, Albers P, Antoch G, Rabenalt R (2014) Prospective evaluation of magnetic resonance imaging guided in-bore prostate biopsy versus systematic transrectal ultrasound guided prostate biopsy in biopsy naive men with elevated prostate specific antigen. The Journal of urology 192 (5):1374-1379. https://doi.org/10.1016/j.juro.2014.05.090.