活检时未发现的丝布状和导管前前列腺癌与不良结果有关
Undetected Cribriform and Intraductal Prostate Cancer at biopsy is associated with adverse outcomes
影响因子:5.80000
发表日期:2025 Mar
作者:
Rui M Bernardino, Leyi B Yin, Katherine Lajkosz, Jessica G Cockburn, Marian Wettstein, Rashid K Sayyid, Rui Henrique, Luís Campos Pinheiro, Theodorus van der Kwast, Neil E Fleshner
摘要
前列腺癌的导管内癌（IDC）和纤维状模式（CRIB）越来越被认为是预后不良的独立预后，无论是在前列腺活检中和根治性前列腺切除术（RP）标本中，我们项目的目的是我们项目的两种特征对这些特征的影响以及对201.2月份的影响范围2的影响。 学习。使用多元COX比例危害模型检查了生化衰竭的预测因子。在接受RP的836例患者中，233例（27.9％）患有CRIB，125例（15.0％）在前列腺活检中具有IDC，具有IDC和CRIB的71例（8.5％）患者。关于活检时的IDC/CRIB状态，217例（26％）患者患有假阴性活检，332（39.7％）进行了真实的活检，256（30.6％）（30.6％）显示了一个真正的阳性活检，24（3.7％）表现出相对于两种模式的假阳性活检。 When comparing false-negative, false-positive, true-negative and true-positive biopsies for IDC/Crib, we found that patients with a false-negative biopsy for IDC/Crib versus those with a true-negative biopsy for IDC/Crib disclosed a rate of advanced pathological stage (≥pT3) which was twice that of patients with a true-negative biopsy for IDC/Crib: 56.8%分别为28.1％（p <0.001）。在多变量COX分析中，RP之前的log PSA（危险比[HR] 2.07，95％CI 1.53-2.82; P <0.001），活检时的正核的较高百分比（≥33％）（≥33％）（HR 1.68，95％CI 1.07-2.63; P = 0.024; P = 0.024; P = 0.024; CI 1.41-3.25; p <0.001）与IDC/CRIB的假阴性活检的风险增加显着相关，与真正的阴性活检相比，IDC/CRIB的风险与更高的BCR和晚期病理阶段有关。
Abstract
Intraductal carcinoma (IDC) and cribriform pattern (Crib) of prostate cancer are increasingly recognized as independent prognosticators of poor outcome, both in prostate biopsies and radical prostatectomy (RP) specimens.The aim of our project is to assess the impact of false negative biopsies for these two characteristics on oncological outcomes.Patients who underwent RP between January 2015 and December 2022 were included in the study. Predictors of Biochemical Failure were examined using a multivariate Cox proportional hazards model.Among the 836 patients who underwent RP, 233 (27.9%) had Crib, and 125 (15.0%) had IDC on prostate biopsy, with 71 (8.5%) patients having both IDC and Crib. Concerning IDC/Crib status at biopsy, 217 (26%) patients had a false-negative biopsy, 332 (39.7%) had a true-negative biopsy, 256 (30.6%) showed a true-positive biopsy, and 24 (3.7%) exhibited a false-positive biopsy, with respect to either pattern. When comparing false-negative, false-positive, true-negative and true-positive biopsies for IDC/Crib, we found that patients with a false-negative biopsy for IDC/Crib versus those with a true-negative biopsy for IDC/Crib disclosed a rate of advanced pathological stage (≥pT3) which was twice that of patients with a true-negative biopsy for IDC/Crib: 56.8% versus 28.1%, respectively (p < 0.001). On multivariate Cox analysis, log PSA before RP (hazard ratio [HR] 2.07, 95% CI 1.53-2.82; p < 0.001), a higher percentage of positive cores at biopsy ( ≥ 33%) (HR 1.68, 95% CI 1.07-2.63; p = 0.024), and false negative biopsy for IDC/Crib (HR 2.14, 95% CI 1.41-3.25; p < 0.001), were each significantly associated with an increased risk of BCR.A false-negative biopsy for IDC/Crib is independently associated with higher risk of BCR and advanced pathological stage compared to a true negative biopsy.