按PI-RADS评分分层优化男性活检策略：一项系统综述与网络荟萃分析。
完整摘要 · 中文译文
前列腺癌是全球男性中第二常见的癌症。诊断技术的进步，尤其是多参数磁共振成像和前列腺影像报告与数据系统，提高了检测的精确度。然而，对于前列腺影像报告与数据系统评分为3-5分的病灶，最佳活检策略仍不确定。在此我们表明，对于前列腺影像报告与数据系统3-5分病灶，饱和靶向活检联合同侧系统活检与靶向活检，其临床有意义前列腺癌的检出率与系统活检联合靶向活检的方法相当，同时减少了不必要的活检。单纯靶向活检仍然不够，且不支持在前列腺影像报告与数据系统5分病灶中省略系统活检。这些发现支持基于前列腺影像报告与数据系统评分的个体化活检策略，从而优化资源分配并最大限度减少过度诊断。有必要在更大规模队列中采用标准化方案进行进一步验证。
完整摘要 · 英文原文
Prostate cancer is the second most common cancer in men globally. Advances in diagnostic techniques, particularly multiparametric magnetic resonance imaging and the Prostate Imaging Reporting and Data System, have enhanced detection precision. However, optimal biopsy strategies for lesions with Prostate Imaging Reporting and Data System scores of 3-5 remain uncertain. Here we show that saturation targeted biopsy and ipsilateral systematic biopsy combined with targeted biopsy achieve comparable detection rates of clinically significant prostate cancer to the combined systematic and targeted biopsy approach for Prostate Imaging Reporting and Data System 3-5 lesions, while reducing unnecessary biopsies. Targeted biopsy alone remains insufficient, and omitting systematic biopsy in Prostate Imaging Reporting and Data System 5 lesions is not supported. These findings support tailored biopsy strategies based on Prostate Imaging Reporting and Data System scores, optimizing resource allocation and minimizing overdiagnosis. Further validation in larger cohorts with standardized protocols is necessary.