Füzyon Biyopsi Sonrası Prostat Kanseri Saptanan Hastalarda Biyopsi Sonrası Patoloji ile Radikal Prostatektomi Sonrası Patolojinin Karşılaştırılması

Year 2023, Volume: 33 Issue: 5, 576 - 581, 25.10.2023

Emre Altıntaş , Mehmet Kaynar , Özcan Kılıç , Ali Furkan Batur , Murat Gül , Halil Özer , Murat Celik , Serdar Göktaş

https://doi.org/10.54005/geneltip.1314371

Abstract

Amaç:Füzyon biyopsisi sonrası prostat kanseri (PCa) saptanan hastaların radikal prostatektomi (RP) sonrası final patolojileri ile biyopsi sonrası patolojilerini Uluslararası Ürolojik Patoloji Derneği (ISUP) derecelendirme sistemine göre karşılaştırmak.
Gereç ve Yöntem: Bu retrospektif çalışmada Ocak 2020-Ağustos 2022 yılları arasında füzyon biyopsi ve beraberinde sistematik biyopsi yapılan 182 hastanın verileri tarandı. Bu hastaların tümü multiparametrik MRG (mp-MRG) görüntülemesi yapılan PIRADS-3 lezyonu olan ve biyopsi naiv hastalardı. Biyopsi sonucunda PCa saptanan 89 hasta çalışmaya dahil edildi. Hastaların yaş, PSA, PSA dansitesi, PI-RADS'a göre lezyon dereceleri incelendi. Bu hastalardan RP yapılan 60 hastanın biyopsi sonrası (füzyon ve sistematik biyopsi) patoloji sonuçlarıyla RP sonrası final patoloji sonuçları karşılaştırıldı.
Bulgular: Füzyon biyopsisi ve RP sonrası patolojik sonuçlar karşılaştırıldı. Her bir ISUP derecesi için RP ve füzyon biyopsisi arasındaki bireysel uyum orta ila neredeyse mükemmeldi (0,558 ila 0,848). RP ve füzyon biyopsisi arasındaki genel uyum değerlendirildiğinde, ağırlıklı kappa 0,721 (%95 CI: 0,577 ila 0,865) olarak hesaplandı ve bu uyum önemli uyum olarak belirlendi. Diğer yandan, RP sonrası sistematik biyopsi ve patoloji sonuçları arasındaki genel uyum ağırlıklı kappa 0,544 (%95 GA: 0,405 ila 0,683) olarak hesaplanmış ve bu uyum orta düzeyde uyum olarak belirlenmiştir.
Sonuç: Çalışmamızda füzyon biyopsi sonrası patoloji sonucuyla RP sonrası final patoloji arasındaki uyumun standart TRUS prostat biyopsisine göre daha yüksek oranda olduğunu gösterdik. Bu uyumun hastaların tedavisinin düzenlenmesinde ve takibinde önemli olduğunu düşünüyoruz.

Keywords

Prostat kanseri, mp-MRG, füzyon biyopsi, ISUP derecesi

Comparison of Post Biopsy Pathology and Post Radical Prostatectomy Pathology in Patients with Prostate Cancer Detected After Fusion Biopsy

Abstract

Aims: To compare the post-radical prostatectomy (RP) final pathologies and post-biopsy pathologies of the patients diagnosed with prostate cancer (PCa) after fusion biopsy according to the International Society of Urological Pathology (ISUP) grading system.
Material and Methods: In this retrospective study, data of 182 patients who underwent fusion biopsy and concomitant systematic biopsy between January 2020 and August 2022 was reviewed. All these patients were biopsy naive with PIRADS-3 lesions according to the multiparametric MRI (mp-MRI) imaging. A total of 89 patients with PCa detected by biopsy were included in the study. Age, PSA, PSA density, and lesion grades according to PI-RADS were analysed. The post-biopsy (fusion and systematic biopsy) pathology results of 60 patients who underwent RP were compared with the final pathology results after RP.
Results: Pathological results after fusion biopsy and RP were compared. The individual agreement between RP and fusion biopsy for each ISUP grade was moderate to almost excellent (0.558 to 0.848). When the overall agreement between RP and fusion biopsy was evaluated, the weighted kappa was calculated as 0.721 (95% CI: 0.577 to 0.865), which was determined as substantial significant agreement. On the other hand, the overall agreement between systematic biopsy and pathology results after RP was calculated as weighted kappa 0.544 (95% CI: 0.405 to 0.683) and this agreement was determined as moderate agreement.
Conclusion: Our study showed that the concordance between the pathology result after fusion biopsy and the final pathology after RP was higher than the standard TRUS prostate biopsy. We think this compliance is crucial in the regulation and follow-up of the treatment of the patients.

Keywords

prostate cancer, fusion biopsy, ISUP grade, mp-MRG

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