前列腺癌K^(trans)值与肿瘤Gleason评分的相关性:Meta分析

Correlation of K^(trans) Value with Gleason Score in Prostate Cancer:A Meta-analysis

目的运用Meta分析综合评价前列腺癌磁共振动态增强扫描(DCE-MRI)定量参数K^(trans)值与肿瘤Gleason评分的相关性,探讨K^(trans)值是否可以用于无创性地预测肿瘤的恶性程度及预后。资料与方法检索Pub Med、Medline、Cochrane图书馆、中国知网、万方数据库收录的2000年1月—2015年11月公开发表的关于前列腺癌DCE-MRI定量参数K^(trans)值及Gleason评分之间的相关性的中英文文献,提取文献中的相关系数r值,对纳入文献的r值进行分析。结果共10篇文献符合纳入标准,其中英文4篇,中文6篇,样本量共464例。Meta分析结果显示,通过合并Spearman相关系数rs值进行分析,K^(trans)值与Gleason评分呈弱正相关(r=0.29,P<0.001,95%CI 0.19~0.37)。结论前列腺癌K^(trans)值可以为临床穿刺活检提供一定的影像学依据,但是否可以成为无创性预测肿瘤恶性程度及预后的可靠指标,其可行性及准确性需要更多的研究验证。

Purpose Using meta-analysis to explore the association between Ktrans value, a quantitative parameter of dynamic contrast-enhanced magnetic resonance imaging（DCEMRI） of prostate cancer, and Gleason score, and to explore whether Ktrans value can be a non-invasive indicator to predict the degree and prognosis. Materials and Methods Pub Med, Medline, Cochrane library, CNKI and Wanfang database were searched for studies discussing the correlation between the quantitative parameter Ktrans value of DCEMRI and Gleason score in prostate cancer. Only studies published in English or Chinese from January 2000 to November 2015 were included. Correlation coefficient r values were extracted from each study. Results A total of 10 articles met the inclusion criteria, of which 4 were in English and 6 were in Chinese. There were a total of 464 lesions. Metaanalysis with Spearman correlation rs evaluation showed that the Ktrans value was slightly positively correlated with the Gleason score（r=0.29, P0.001, 95% CI 0.19-0.37）. Conclusion Ktrans value in prostate cancer can provide imaging evidence for biopsy. The feasibility and accuracy of using Ktrans as an indicator of the degree of malignancy and prognosis require further research verification.