Prostate cancer is a public health problem in Senegal. It is one of the most common cancers in men and can be detected early by PSA measurement and confirmed by the pathological study which specifies the histological ...Prostate cancer is a public health problem in Senegal. It is one of the most common cancers in men and can be detected early by PSA measurement and confirmed by the pathological study which specifies the histological type and evaluates the histoprognostic scores (Gleason and pTNM). We did not find any anatomopathological study highlighting a link between the PSA t rate and histoprognostic Gleason scores in Senegal. Objective: We carried out this work aimed at determining whether there is a correlation between the PSA t rate and the histoprognostic Gleason score, in our context. Methodology: This is a retrospective, descriptive and analytical study conducted from January 2013 to October 2021, based on histologically proven prostate cancer cases with a specified PSA level, diagnosed in the pathological anatomy and cytology laboratory of Aristide Le Dantec hospital. Results: We identified 654 cases of prostate cancer. The average age was 68.59 ± 5.8 years with extremes of 40 years to 92 years. More than half of our cohort presented a clinical stage T2c, i.e. 56.94%. The average prostate volume on ultrasound was 81.81 ± 66 cc. The median PSA t was 110.5 ng/ml, with extremes ranging from 2 ng/ml to 74,770 ng/ml. Prostatic adenocarcinoma was the only histological type found in our patients. There was a predominance of Gleason score 6 (PICU grade group 1) observed in 35.17% of patients. Well-differentiated cancers were predominant and represented 35.17%. There was a statistically significant positive correlation between PSA t level and Gleason score (Spearman’s Rho = 0.305, p = 0.000). Conclusion: This study shows that in the Senegalese population, in patients with prostate cancer, the higher the PSA t level rises above normal, the higher the Gleason score tends to be.展开更多
文摘目的旨在评估动态对比增强磁共振成像(dynamic contrast-enhancement magnetic resonance imaging,DCE-MRI)结合扩散加权成像(diffusion weighted imaging,DWI)在预测前列腺癌(prostate cancer,PCa)Ki-67表达和Gleason评分中的诊断效能。材料与方法回顾性分析了2019年1月至2023年10月自贡市第四人民医院收治的66例PCa患者的临床及影像资料。结合T2WI、DWI序列和由DWI自动计算出的表观扩散系数(apparent diffusion coeffieient,ADC),在DCE-MRI图像上手动勾画肿瘤感兴趣区(region of interest,ROI),计算ROI药代动力学参数,包括容积转运常数(volume transfer contrast,K^(trans))、速率常数(rate contrast,K_(ep))、血管外细胞外容积分数(extravascular extracellular volume fraction,Ve),并测量ADC值。根据靶向穿刺病理诊断Gleason评分和Ki-67表达水平,分为Ki-67高表达组(Ki-67>10%)和低表达组(Ki-67≤10%),Gleason评分低级别(GG 1~2)和高级别(GG 3~5)组。组间差异比较使用两独立样本t检验或非参数检验,采用Spearman相关分析评价DCE-MRI参数和ADC值与Ki-67、Gleason评分的相关性,并建立logistic回归模型,通过受试者工作特征(receiver operating characteristic,ROC)曲线评估诊断效能。结果ADC值与Ki-67表达、Gleason评分均呈负相关(P<0.001),K^(trans)、K_(ep)、Ve与Ki-67表达均呈正相关(P<0.001),K^(trans)、K_(ep)与Gleason评分均呈正相关(P<0.001)。Ki-67高、低表达组K^(trans)、K_(ep)、Ve、ADC值比较差异均具有统计学意义(P<0.01),Gleason评分高、低级别组K^(trans)、K_(ep)、ADC值比较差异均具有统计学意义(P<0.01);Ki-67表达的ROC曲线分析显示,联合模型K^(trans)+K_(ep)+Ve+ADC诊断效能最好,曲线下面积(area under the curve,AUC)为0.940;Gleason评分分级的ROC曲线分析显示,联合模型K^(trans)+K_(ep)+ADC诊断效能最好,AUC为0.861。结论DCE-MRI的药代动力学参数和ADC值相结合,在预测PCa的Ki-67表达和Gleason评分中显示出高诊断效能。联合使用DCE-MRI定量参数与ADC值可提高PCa病理分级和生物侵袭性的预测准确性。
文摘Prostate cancer is a public health problem in Senegal. It is one of the most common cancers in men and can be detected early by PSA measurement and confirmed by the pathological study which specifies the histological type and evaluates the histoprognostic scores (Gleason and pTNM). We did not find any anatomopathological study highlighting a link between the PSA t rate and histoprognostic Gleason scores in Senegal. Objective: We carried out this work aimed at determining whether there is a correlation between the PSA t rate and the histoprognostic Gleason score, in our context. Methodology: This is a retrospective, descriptive and analytical study conducted from January 2013 to October 2021, based on histologically proven prostate cancer cases with a specified PSA level, diagnosed in the pathological anatomy and cytology laboratory of Aristide Le Dantec hospital. Results: We identified 654 cases of prostate cancer. The average age was 68.59 ± 5.8 years with extremes of 40 years to 92 years. More than half of our cohort presented a clinical stage T2c, i.e. 56.94%. The average prostate volume on ultrasound was 81.81 ± 66 cc. The median PSA t was 110.5 ng/ml, with extremes ranging from 2 ng/ml to 74,770 ng/ml. Prostatic adenocarcinoma was the only histological type found in our patients. There was a predominance of Gleason score 6 (PICU grade group 1) observed in 35.17% of patients. Well-differentiated cancers were predominant and represented 35.17%. There was a statistically significant positive correlation between PSA t level and Gleason score (Spearman’s Rho = 0.305, p = 0.000). Conclusion: This study shows that in the Senegalese population, in patients with prostate cancer, the higher the PSA t level rises above normal, the higher the Gleason score tends to be.
