Objectives: To evaluate the density percentage of biopsy-positive cores (BPCs) relative to prostate volume, defined as Id-BPC, compared with BPCs as a predictor of pelvic lymph node invasion (PLNI) in EAU high-risk prostate cancer (PCa) treated and staged with robot-assisted radical prostatectomy (RARP). Methods: Overall, 254 EAU high-risk patients were treated with RARP between January 2013 and December 2021. Results: Overall, PLNI was detected in 23.2% of patients who were more likely to present with standard adverse clinical features; likewise, on multivariate models, PLNI was independently predicted by both BPC and Id-BPC with the latter showing a stronger association (OR = 1.926; 95% CI: 1.246–2.977;p= 0.003) than the former (OR = 1.028; 95% CI: 1.014–1.042;p< 0.0001); moreover, when cancer density was categorized at Id-BPC ≥ 1.0 versus < 1.0, the prediction was even stronger (OR = 3.535; 95% CI: 1.551–8.054;p= 0.003). Conclusions: In the investigated population, Id-BPC was a stronger predictor of PLNI than BPC; accordingly, as Id-BPC increased, patients were more likely to have PLNI; equivalently, subjects presenting with Id-BPC less than one were 3.5 times less likely to have PLNI. This information has implications for clinical practice as well as for computing nomograms or patterns of artificial intelligence networks.
目的：评估活检阳性核心密度百分比（Id-BPC，定义为活检阳性核心数与前列腺体积的比值）与传统活检阳性核心数（BPC）在预测欧洲泌尿外科协会（EAU）高危前列腺癌患者接受机器人辅助根治性前列腺切除术（RARP）治疗后盆腔淋巴结侵犯（PLNI）方面的效能差异。方法：回顾性分析2013年1月至2021年12月期间接受RARP治疗的254例EAU高危前列腺癌患者资料。结果：总体PLNI检出率为23.2%，此类患者更常出现典型不良临床特征。多变量模型显示，BPC与Id-BPC均为PLNI的独立预测因子，其中Id-BPC的预测效能更强（OR=1.926；95%CI：1.246–2.977；p=0.003），而BPC的OR值为1.028（95%CI：1.014–1.042；p<0.0001）。当以Id-BPC≥1.0与<1.0为界值进行分层分析时，预测效能进一步增强（OR=3.535；95%CI：1.551–8.054；p=0.003）。结论：在本研究人群中，Id-BPC对PLNI的预测能力优于BPC。Id-BPC值越高，患者发生PLNI的风险越大；当Id-BPC值低于1时，患者发生PLNI的可能性降低3.5倍。该发现对临床实践、列线图构建及人工智能网络模型开发具有重要参考价值。
肿瘤(癌症)患者之家