Multiparametrik prostat MRG'nin prostat biyopsi ve radikal prostatektomi histopatolojisi ile korelasyonu
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Dosyalar
Tarih
2022
Yazarlar
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Yayıncı
Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Prostat kanseri erkeklerde akciğer kanserinden sonra kanserden dolayı ölümlerden sorumlu en sık kanserdir. Bu çalışmada multiparametrik MRG sonuçları ile prostat biopsi ve radikal prostatektomi spesimeninin histopatolojisi ile karşılaştırarak multiparametrik MRG nin PİRADS skorlamasının prostat kanserinin gleason skoru hakkında bilgi sahibi olmayı amaçladık. Materyal ve Metod: Hatay Mustafa Kemal Üniversitesi Tıp Fakültesi Üroloji Anabilim Dalı Kliniği'nde Ocak 2019 ile Nisan 2021 yılları arasında polikliniğe PSA yüksekliği ile başvuran 214 hasta çalışmaya dahil edildi. Tüm hastalara biyopsi işleminden önce multiparemetrik MRG görüntülemesi yapıldı. PIRADS skorlaması aynı radyolog tarafından gerçekleştirildi. Prostat biopsisi deneyimli ürologlar tarafından sistematik olarak 12 kadran biopsi olacak şekilde yapıldı. Bulgular: Hastaların multiparametrik MRI sonuçları değerlendirildiğinde; En sık görülen paternler PIRADS 2 ve PIRADS 4 olarak görülmekte bunları ikinci sıklıkla PIRADS 3 lezyon ve daha sonra PIRADS 5 lezyon ile en az olan PIRADS1 lezyon takip etmektedir. Pirads değeri üzerinden prostat kanserini tahmini için analiz uygulandığında, hastalık tanısı için ROC analizi sonucu Eğiri Altında Kalan (Area Under of the Curve) değerinin istatistiksel olarak anlamlı düzeylerde gözlenmiştir (EAA 0,860: p<0,001) ve PIRADS 3 ve üzerinde %81 sensitivite ve %75 spesifite ile kanseri predikte edebilmektedir. Korelasyon analizinde ise PIRADS ile PSA değeri arasında düşükte olsa anlamlı korelasyon gösterdiği (r 0,252; p <0.001) saptanmıştır. Sonuç: PSA yüksekliği ile gelen hastaların ve mpMRG ile birlikte prostat kanseri saptamada ki gücünün yüksek olduğunu tespit ettik. Ayrıca ISUP derecelemesi ve PIRADS arasında güçlü ilişki bulunduğunu saptadık. Sonuç olarak mpMRG ile hastaların patolojilerinin predikte edilebileceği düşünülmektedir.
Objective: Prostate cancer is the most common cancer responsible for cancer deaths in men after lung cancer. In this study, we aimed to have information about the Gleason score of prostate cancer by PIRADS scoring of multiparametric MRI by comparing multiparametric MRI results with the histopathology of prostate biopsy and radical prostatectomy specimen. Materials-Methods: 214 patients who applied to the outpatient clinic of Hatay Mustafa Kemal University Faculty of Medicine, Department of Urology between January 2019 and April 2021 with elevated PSA were included in the study. All patients underwent multiparametric MRI before the biopsy procedure. PIRADS scoring was performed by the same radiologist. Prostate biopsy was systematically performed by experienced urologists as 12 quadrant biopsies. Results: When the multiparametric MRI results of the patients are evaluated;The most common patterns are seen as PIRADS 2 and PIRADS 4, followed by PIRADS 3 lesions, followed by PIRADS5 lesions, and PIRADS1 lesions, which are the least frequent. When the analysis was applied to predict prostate cancer over the pyrads value, the ROC analysis result for the diagnosis of the disease showed statistically significant levels of Area Under of the Curve (EAA 0.860: p<0.001), with a sensitivity of 81% and a sensitivity of 3 and above PIRADS 3 and above. It can predict cancer with 75 specificities. In the correlation analysis, it was found that there was a low but significant correlation between PIRADS and PSA value (r 0.252; p <0.001). Conclusion: We found that patients presenting with elevated PSA and mpMRI had a high power in detecting prostate cancer. We also found that there is a strong relationship between ISUP rating and PIRADS. As a result, it is thought that the pathology of the patients can be predicted with mpMRI.
Objective: Prostate cancer is the most common cancer responsible for cancer deaths in men after lung cancer. In this study, we aimed to have information about the Gleason score of prostate cancer by PIRADS scoring of multiparametric MRI by comparing multiparametric MRI results with the histopathology of prostate biopsy and radical prostatectomy specimen. Materials-Methods: 214 patients who applied to the outpatient clinic of Hatay Mustafa Kemal University Faculty of Medicine, Department of Urology between January 2019 and April 2021 with elevated PSA were included in the study. All patients underwent multiparametric MRI before the biopsy procedure. PIRADS scoring was performed by the same radiologist. Prostate biopsy was systematically performed by experienced urologists as 12 quadrant biopsies. Results: When the multiparametric MRI results of the patients are evaluated;The most common patterns are seen as PIRADS 2 and PIRADS 4, followed by PIRADS 3 lesions, followed by PIRADS5 lesions, and PIRADS1 lesions, which are the least frequent. When the analysis was applied to predict prostate cancer over the pyrads value, the ROC analysis result for the diagnosis of the disease showed statistically significant levels of Area Under of the Curve (EAA 0.860: p<0.001), with a sensitivity of 81% and a sensitivity of 3 and above PIRADS 3 and above. It can predict cancer with 75 specificities. In the correlation analysis, it was found that there was a low but significant correlation between PIRADS and PSA value (r 0.252; p <0.001). Conclusion: We found that patients presenting with elevated PSA and mpMRI had a high power in detecting prostate cancer. We also found that there is a strong relationship between ISUP rating and PIRADS. As a result, it is thought that the pathology of the patients can be predicted with mpMRI.
Açıklama
Anahtar Kelimeler
Üroloji, Urology, multiparametrik MRI, PIRADS, Prostat kanseri, ISUP, Prostat Biyopsisi, Multiparametric Prostate MRI, Prostate Cancer,ISUP,Prostat Biopsy
