快速现场评估在前列腺穿刺活检中的应用价值

On Application Value of Rapid On-site Evaluation in Biopsy of Prostate

目的探讨快速现场评估(rapid on-site evaluation,ROSE)在前列腺穿刺活检中的应用价值。方法回顾性分析2020年10月~2021年6月47例MRI可疑前列腺癌行MRI-超声融合穿刺同期行ROSE检测的资料。术前均行多参数磁共振(multiparametric magnetic resonance imaging,mpMRI)检查,存在前列腺成像报告和数据系统(Prostate Imaging-Reporting and Data System,PI-RADS)评分4~5分位点110个。均行MRI-超声融合穿刺,每个位点除标准穿刺外额外穿刺2针进行ROSE检测。结果47例穿刺过程顺利,术后无严重并发症发生。共进行110个PI-RADS 4~5分位点穿刺,病理诊断前列腺癌位点53个,阳性检出率48.2%(53/110)。110个位点均进行ROSE检测,以穿刺标本石蜡病理为金标准,ROSE检测前列腺癌的敏感性67.9%(36/53),特异性100%(57/57),准确率84.5%(93/110),阳性预测值100%(36/36),阴性预测值77.0%(57/74)。结论ROSE技术运用于前列腺穿刺术中诊断,结果准确可靠,特异性和阳性预测值达100%。

Objective To evaluate the application value of rapid on-site evaluation(ROSE)applied in the biopsy for diagnosis of prostate cancer.Methods Clinical data of 47 patients with suspected prostate cancer by MRI and targeted MRI-ultrasound combined puncture with simultaneous ROSE diagnosis in our hospital from October 2020 to June 2021 were analyzed retrospectively.All the patients underwent multiparametric magnetic resonance imaging(mpMRI)examination before operation.There were 110 points with the Prostate Imaging-Reporting and Data System(PI-RADS)score of 4-5.MRI-ultrasound combined puncture was given in all the patients.In addition to standard puncture,2 needles were punctured at each point for ROSE detection.Results All the 47 patients successfully completed the puncture,and there were no serious complications after operation.All the 110 loci with PI-RADS score of 4-5 were given ROSE diagnosis.Using paraffin pathology of puncture specimens as the gold standard,the ROSE diagnosis of prostate cancer showed a sensitivity of 67.9%(36/53),a specificity of 100%(57/57),an accuracy of 84.5%(93/110),a positive predictive value of 100%(36/36),and a negative predictive value of 77.0%(57/74).Conclusion The application of ROSE in the biopsy for diagnosis of prostate cancer is simple,accurate,and reliable,with the specificity and positive predictive value reaching 100%.