Prostata spesifik antijen değeri 4-10 ng/ml aralığında olan hastalarda multiparametrik prostat manyetik rezonans görüntülemenin prostat kanseri tanısındaki yerinin retrospektif araştırılması
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Dosyalar
Tarih
2019
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: Multiparametrik Prostat Manyetik Rezonans Görüntüleme (MpMRG) son zamanlarda prostat kanseri tanı ve evrelemesinde gittikçe daha yaygın kullanılarak, tecrübe ve cihaz kalitesininde artmasıyla önemi dahada artmıştır. Çalışmamızda PSA değerleri 4-10 ng/ml olan, radikal prostatektomi öncesi MpMRG çekilmiş hastalarda MRG bulguları ile histopatolojik ilişki ve uyumun arasındaki ilişkinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Ocak 2017 – Haziran 2019 tarihleri arasında, Ege Üniversitesi Tıp Fakültesi Üroloji Kliniği'nde, prostat kanseri sebebiyle radikal prostatektomi yapılan, operasyon öncesi MpMRG uygulanan ve diğer dahil edilme kriterlerini karşılayan 90 hastanın verisi incelenmiştir. Hastalara ait yaş, operasyon öncesi Prostat Spesifik Antijen (PSA) değeri retrospektif olarak hasta dosyalarından toplanmıştır. Patoloji spesmeni tekrar incelenerek operasyon sonrası gleason skoru, Uluslararası Ürolojik Patoloji Derneği (ISUP) derecesi, diğer patolojik bulgular (lenf nodu tutulumu ve ekstraprostatik yayılım), USG eşliğinde transrektal prostat biyopsi öncesinde yapılan MpMRG tekrar incelenerek PIRADS skoru, ekstrakapsüler uzanım, seminal vezikül invazyonu, nörovasküler demet invazyonu ve lenf nodu tutulumu kaydedilmiştir. İstatistiksel analiz için IBM SPSS Statistics 25.0 Programı kullanıldı. Bulgular: MpMRG'de seminal vezikül invazyonu saptanan hastaların %66.6'ı, ekstrakapsüler uzanım saptanan hastaların %55.5'i, lenf nodu tutulumu saptanan hastaların %40'ı, nörovasküler demet invazyon saptanan hastaların %88.2'i histopatolojik olarak korele edildi. PIRADS skorları ile ISUP derece grupları (p=0.007) ve PIRADS skorları ile Gleason skorları arasında(p=0.023) anlamlı ilişki gösterilmiştir. PIRADS skorları ile histopatolojik olarak cerrahi sınır(p=0.5), ekstrakapsüler yayılım (p=0.161), lenf nodu tutulumu (p=0.936), perinöral invazyon durumu(p=0.35), pT evre(p=0.222), seminal vezikül invazyonu (p=0.064) arasında anlamlı ilişki saptanmadı. Sonuç: MpMRG tekniği, ekipmanı, PIRADS skorlama sistemi ve yorumlayıcıların tecrübe ve bilgisi geliştirildikçe, tetkikin tanı koyma yeteneği de artacaktır. MpMRG'de evreleme doğruluğu arttıkça hastaların tedavi planlaması yada önceliği 2 de değişebilir. MpMRG'nin tanıdaki rolü daha büyük hasta popülasyonuyla ve prospektif olarak yapılacak çalışmalarla geliştirilebilir.
Background and Aim: Multiparametric Prostate Magnetic Resonance Imaging (MpMRI) has recently become more and more widely used in the diagnosis and staging of prostate cancer and its importance has increased with increasing experience and device quality. In this study, we aimed to investigate the relationship between MRI findings and histopathological correlation and compliance in patients with PSA values of 4-10 ng / ml who underwent MpMRI before radical prostatectomy. Materials and Methods: 90 patients who underwent radical prostatectomy for prostate cancer between January 2017 and June 2019 at the Urology Clinic of Ege University School of Medicine and who underwent pre-operative MpMRI also who met the other inclusion criteria were evaluated. Age, preoperative Prostate Specific Antigen (PSA) values of patients were collected retrospectively from patient files. The pathology specimen was re-examined and postoperative gleason score, International Association of Urological Pathology (ISUP) grade, other pathological findings (lymph node involvement and extraprostatic spread); MpMRI performed before the USG-guided transrectal prostate biopsy was re-examined thus PIRADS score, extracapsular extension, seminal vesicle invasion neurovascular bundle invasion and lymph node involvement were recorded. IBM SPSS Statistics 25.0 Program was used for statistical analysis. Results: 66.6% of patients with seminal vesicle invasion, 55.5% of patients with extracapsular extension, 40% of patients with lymph node involvement, 88.2% of patients with neurovascular bundle invasion were correlated histopathologically with MpMRI. PIRADS scores were significantly correlated with ISUP rating groups (p = 0.007) and Gleason scores (p = 0.023). No significant relationship was found between PIRADS scores and histopathological surgical margin (p = 0.5), extracapsular extension (p = 0.161), lymph node involvement (p = 0.936), perineural invasion status (p = 0.35), pT stage (p = 0.222), seminal vesicle invasion (p = 0.064). Conclusions: As the experience and knowledge of MpMRI technique, equipment, PIRADS scoring system and interpreters are improved, the diagnostic ability of the examination will increase. As the staging accuracy in MpMRI improves, treatment planning or priority may change. The role of MpMRI in diagnosis can be improved with larger patient population and prospective studies.
Background and Aim: Multiparametric Prostate Magnetic Resonance Imaging (MpMRI) has recently become more and more widely used in the diagnosis and staging of prostate cancer and its importance has increased with increasing experience and device quality. In this study, we aimed to investigate the relationship between MRI findings and histopathological correlation and compliance in patients with PSA values of 4-10 ng / ml who underwent MpMRI before radical prostatectomy. Materials and Methods: 90 patients who underwent radical prostatectomy for prostate cancer between January 2017 and June 2019 at the Urology Clinic of Ege University School of Medicine and who underwent pre-operative MpMRI also who met the other inclusion criteria were evaluated. Age, preoperative Prostate Specific Antigen (PSA) values of patients were collected retrospectively from patient files. The pathology specimen was re-examined and postoperative gleason score, International Association of Urological Pathology (ISUP) grade, other pathological findings (lymph node involvement and extraprostatic spread); MpMRI performed before the USG-guided transrectal prostate biopsy was re-examined thus PIRADS score, extracapsular extension, seminal vesicle invasion neurovascular bundle invasion and lymph node involvement were recorded. IBM SPSS Statistics 25.0 Program was used for statistical analysis. Results: 66.6% of patients with seminal vesicle invasion, 55.5% of patients with extracapsular extension, 40% of patients with lymph node involvement, 88.2% of patients with neurovascular bundle invasion were correlated histopathologically with MpMRI. PIRADS scores were significantly correlated with ISUP rating groups (p = 0.007) and Gleason scores (p = 0.023). No significant relationship was found between PIRADS scores and histopathological surgical margin (p = 0.5), extracapsular extension (p = 0.161), lymph node involvement (p = 0.936), perineural invasion status (p = 0.35), pT stage (p = 0.222), seminal vesicle invasion (p = 0.064). Conclusions: As the experience and knowledge of MpMRI technique, equipment, PIRADS scoring system and interpreters are improved, the diagnostic ability of the examination will increase. As the staging accuracy in MpMRI improves, treatment planning or priority may change. The role of MpMRI in diagnosis can be improved with larger patient population and prospective studies.
Açıklama
Anahtar Kelimeler
Prostat Kanseri, Multiparametrik MRG, Histopatolojik Korelasyon, Prostate Cancer, Multiparametric MRI, Histopathological Correlation
