摘要
目的系统性比较分析靶向融合穿刺与系统性穿刺在前列腺癌临床诊断方面的差异。方法人工通过计算机检索Pub Med、Medline、中国知网、中国生物医学文献数据库、万方数据库中关于靶向融合穿刺与系统性穿刺在前列腺癌检出率方面的对比研究。检索时间从建库开始至2016年10月，分别由2名评价员制定纳入、排除标准，同时对纳入文献进行资料提取及质量评价。采用RevMan5.3软件对两种穿刺方式对前列腺癌检出率进行荟萃（Meta）分析。结果共纳入15篇临床研究，相关患者5 337例，其中靶向融合穿刺2 667例，系统性穿刺2 670例。Meta分析结果显示靶向融合穿刺的前列腺癌总体检出率显著高于系统性穿刺（OR＝1.16，95% CI 1.04～1.30，P＝0.007）。我们以Gleason评分7分为界，分别对两种穿刺方式对不同危险等级的前列腺癌检出率进行比较研究。结果显示在Gleason≥7分的中高危前列腺癌中，靶向融合穿刺较系统性穿刺在检出率方面具有显著优势（OR＝1.37，95% CI 1.19～1.58，P〈0.05）。而在Gleason评分〈7的低危前列腺癌中，靶向融合穿刺较系统性穿刺的前列腺癌检出率表现较差（OR＝0.76，95% CI 0.65～0.89，P〈0.05）。结论靶向融合穿刺在前列腺癌总体检出率及Gleason≥7分的中高危前列腺癌检出率方面显著优于系统性穿刺，而在Gleason〈7分的低危前列腺癌中系统性穿刺则表现较好。
ObjectiveTo systematically compare the differences in the detection rate of prostate cancer with fusion targeting biopsy and systemic biopsy.Methods A computer-based search of PubMed, Medline, China Biomedical Literature Database and Wanfang database （from the beginning of establishment of library to October 2016） on the detection rate of prostate cancer by fusion targeting biopsy and systemic biopsy was performed manually.The inclusion and exclusion criteria were formulated by 2 reviewers, and the data were extracted and evaluated respectively. RevMan5.3 software was used to analyze the detection rate of prostate cancer by two biopsy methods.ResultsA total of 15 related clinical studies were included, 5 337 cases were enrolled in the study, including 2 667 cases of targeted fusion biopsy and 2 670 cases of routine systemic biopsy. The results showed that the overall detection rate of prostate cancer in targeting fusion biopsy was significantly higher than that of conventional systemic biopsy （OR=1.16, 95% CI 1.04-1.30, P=0.007）. The detection rates of prostate cancer with different risk grades by two biopsy methods were conducted. We found that targeted fusion biopsy had a significant advantage compared with conventional system biopsy （OR=1.37, 95% CI 1.19-1.58, P〈0.05） in middle and high risk prostate cancer with Gleason ≥ 7 points. In low-risk prostate cancer patients with Gleason score 〈7, the detection rate of prostate cancer by targeted fusion biopsy was lower （OR=0.76, 95% CI 0.65-0.89, P〈0.05） than that of conventional systemic biopsy.ConclusionsTargeted fusion biopsy was significantly better than systemic biopsy in the overall detection rate of prostate cancer and the detection rate of the middle and high risk prostate cancer with Gleason ≥7 points. However, systemic biopsy performed better in patients with Gleason〈7 points of low-risk prostate cancer.
作者
张立进
吴斌
查振雷
赵虎
杨伟
陈晓华
姜彬
江岳方
殷金龙
Zhang Lijin Wu Bin Zha Zhenlei Zhao Hu Yang Wei Chen Xiaohua Jiang Bin Jiang Yuefang Yin Jinlong(Department of Urology, Affiliated jiangyin Hospital of the Southeast University Medical College, Jiangyin 214400, China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2017年第22期1694-1698,共5页
National Medical Journal of China
关键词
前列腺癌
靶向融合穿刺
系统性穿刺
临床诊断
META分析
Prostate neoplasms,Fusion targeting biopsy,Systematic biopsy,Clinical diagnosis,Meta-analysis
