文章：

多参数磁共振成像中不可见的前列腺癌：与全前列腺切除术病理特征的相关性分析

Prostate Cancers Invisible on Multiparametric MRI: Pathologic Features in Correlation with Whole-Mount Prostatectomy

原文发布日期：13 December 2023

DOI: 10.3390/cancers15245825

类型: Article

开放获取: 是

英文摘要：

We investigated why some prostate cancers (PCas) are not identified on multiparametric MRI (mpMRI) by using ground truth reference from whole-mount prostatectomy specimens. A total of 61 patients with biopsy-confirmed PCa underwent 3T mpMRI followed by prostatectomy. Lesions visible on MRI prospectively or retrospectively identified after correlating with histology were considered “identified cancers” (ICs). Lesions that could not be identified on mpMRI were considered “unidentified cancers” (UCs). Pathologists marked the Gleason score, stage, size, and density of the cancer glands and performed quantitative histology to calculate the tissue composition. Out of 115 cancers, 19 were unidentified on MRI. The UCs were significantly smaller and had lower Gleason scores and clinical stage lesions compared with the ICs. The UCs had significantly (p< 0.05) higher ADC (1.34 ± 0.38 vs. 1.02 ± 0.30 μm2/ms) and T2 (117.0 ± 31.1 vs. 97.1 ± 25.1 ms) compared with the ICs. The density of the cancer glands was significantly (p= 0.04) lower in the UCs. The percentage of the Gleason 4 component in Gleason 3 + 4 lesions was nominally (p= 0.15) higher in the ICs (20 ± 12%) compared with the UCs (15 ± 8%). The UCs had a significantly lower epithelium (32.9 ± 21.5 vs. 47.6 ± 13.1%,p= 0.034) and higher lumen volume (20.4 ± 10.0 vs. 13.3 ± 4.1%,p= 0.021) compared with the ICs. Independent from size and Gleason score, the tissue composition differences, specifically, the higher lumen and lower epithelium in UCs, can explain why some of the prostate cancers cannot be identified on mpMRI.

摘要翻译： 

本研究旨在通过利用根治性前列腺切除标本的组织病理学全切片作为金标准，探讨为何部分前列腺癌（PCa）在多参数磁共振成像（mpMRI）上无法被识别。研究共纳入61例经活检证实为前列腺癌的患者，所有患者均接受3T mpMRI检查后行前列腺切除术。通过与组织学结果对照，将MRI上（前瞻性或回顾性）可见的病灶定义为“已识别癌”（ICs），而mpMRI无法识别的病灶则定义为“未识别癌”（UCs）。病理学家对癌腺体的格里森评分、分期、大小及密度进行标注，并通过定量组织学分析计算组织成分。在115个癌灶中，有19个在MRI上未被识别。与ICs相比，UCs的病灶体积显著更小，格里森评分和临床分期更低。UCs的表观扩散系数（ADC）（1.34 ± 0.38 vs. 1.02 ± 0.30 μm²/ms）和T2值（117.0 ± 31.1 vs. 97.1 ± 25.1 ms）均显著高于ICs（p < 0.05）。UCs中癌腺体密度显著较低（p = 0.04）。在格里森3+4分级的病灶中，ICs的格里森4级成分占比（20 ± 12%）略高于UCs（15 ± 8%），但差异未达显著水平（p = 0.15）。与ICs相比，UCs的上皮体积显著更低（32.9 ± 21.5 vs. 47.6 ± 13.1%，p = 0.034），而管腔体积显著更高（20.4 ± 10.0 vs. 13.3 ± 4.1%，p = 0.021）。独立于病灶大小和格里森评分，组织成分的差异——特别是UCs中更高的管腔体积和更低的上皮体积——可以解释为何部分前列腺癌在mpMRI上无法被识别。

原文链接：

Prostate Cancers Invisible on Multiparametric MRI: Pathologic Features in Correlation with Whole-Mount Prostatectomy