Background

Population-based prostate-specific antigen (PSA) screening is effective for reducing prostate cancer (PCa)-related mortality rates. In this study, we assessed biopsy-proven maximum cancer core length (MCCL) and maximum cancer diameter on magnetic resonance imaging (MRI; MCDM) in prostate biopsy and multiparametric MRI (mp-MRI) by PCa detection.

Methods

We retrospectively assessed 214 male PCa patients and 187 PCa patients with Prostate Imaging Reporting and Data System version 2 (PI-RADS) category 3–5 lesions in pre-biopsy mp-MRI and targeted biopsy characteristics. The mean biopsy-proven MCCL and MCDM were compared among three PSA screening groups, namely the population-based PSA screening (PBS), opportunistic PSA screening (OPS), and symptomatic outpatient PSA examination (SOP) groups.

Results

The median age and PSA value of the 214 participants were 75 years and 7.9 ng/mL, respectively. In the PBS, OPS, and SOP groups, the median ages were 73, 76, and 76 years, respectively (p = 0.046); PSA values were 7.2, 9.5, and 11.5 ng/mL, respectively (p < 0.001); and biopsy-proven MCCL and MCDM were significantly increased to 7, 10, and 14 mm (p < 0.001) and to 11, 15, and 17 mm (p < 0.001), respectively. In the 187 PCa patients with PI-RADS category 3–5 lesions on mp-MRI, MCDM were 11, 14, and 17 mm (p < 0.001), respectively.

Conclusions

The biopsy-proven MCCL and MCDM were significantly smaller in the PBS and OPS groups than in the SOP group, which suggests that PSA screening detected PCa earlier than in symptomatic patients. PSA screening with MRI could objectively lead to earlier diagnosis based on tumor size.

中文翻译：

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日本京都超老龄区前列腺特异性抗原筛查对前列腺癌患者肿瘤大小的影响

背景

基于人群的前列腺特异性抗原 (PSA) 筛查可有效降低前列腺癌 (PCa) 相关死亡率。在这项研究中，我们评估了前列腺活检和多参数 MRI (mp-MRI) 中前列腺活检中经活检证实的最大癌核长度 (MCCL) 和最大癌直径 (MRI; MCDM)。

方法

我们回顾性评估了 214 名男性前列腺癌患者和 187 名前列腺影像报告和数据系统版本 2 (PI-RADS) 活检前 mp-MRI 类别 3-5 病变和靶向活检特征的前列腺癌患者。比较三个PSA筛查组，即基于人群的PSA筛查（PBS）、机会性PSA筛查（OPS）和症状性门诊PSA检查（SOP）组的平均活检证实MCCL和MCDM。

结果

214 名参与者的中位年龄和 PSA 值分别为 75 岁和 7.9 ng/mL。在 PBS、OPS 和 SOP 组中，中位年龄分别为 73、76 和 76 岁（p  = 0.046）；PSA 值分别为 7.2、9.5 和 11.5 ng/mL ( p  < 0.001)；经活检证实的 MCCL 和 MCDM 分别显着增加至 7、10 和 14 毫米（p  < 0.001）和 11、15 和 17 毫米（p  < 0.001）。在 mp-MRI 上 PI-RADS 3-5 类病变的 187 名 PCa 患者中，MCDM 分别为 11、14 和 17 mm ( p  < 0.001)。

结论

活检证实的 MCCL 和 MCDM 在 PBS 和 OPS 组中显着小于 SOP 组，这表明 PSA 筛查比有症状的患者更早地检测到 PCa。使用 MRI 进行 PSA 筛查可以客观地导致基于肿瘤大小的早期诊断。