Sercan Yilmaz, Mehmet Yilmaz, Serdar Yalcin, Engin Kaya, Eymen Gazel, Halil Cagri Aybal, Hakan Ozdemir, Mehmet Yorubulut, Ali Yusuf Oner, Lutfi Tunc

Prostat Görüntüleme Raporlama ve Veri Sistemi-3 lezyonlarında prostat kanserini öngören temel faktörler

Amaç: Bu çalışmada Prostat Görüntüleme ve Veri Raporlama Sistemi (PI-RADS) 3 lezyonlarında prostat kanserini öngörmede dijital rektal muayene ile PSA dansitesi, lezyonun bölgesel konumu ve prostat boyutunun rolünü araştırmak istedik.Gereç ve Yöntemler: PSA düzeyi yükselmiş ve / veya dijital rektal muayenesi şüpheli olması nedeniyle multiparametrik MR çekilmiş ve biyopsi sonucu PI-RADS 3 olarak raporlanmış toplam 236 hastanın verileri retrospektif olarak incelendi. Prostat kanseri tespit oranı, dijital rektal muayene bulguları, lezyonların yeri, PSA dansite sonuçları, prostat hacmi sonuçları ve alt grup analizleri ile risk sınıflandırılması yapıldı.Bulgular: PI-RADS Skoru 3 olan 137 hasta çalışmaya dahil edildi. Genel prostat kanseri tespit oranı % 26,2 ve klinik önemli prostat kanseri tespit oranı % 4,3’tü. Dijital rektal muayene bulguları (p = 0,001) ve lezyonun periferik zon yerleşimi (p = 0,005) ile prostat kanseri olmayan gruplar arasında anlamlı farklılık bulundu. Dijital rektal muayene (p = 0.001), çok değişkenli lojistik regresyon analizinde PIRADS-3 lezyonlu hastalarda prostat kanserinin bağımsız prediktörü olarak tespit edildi.Sonuç: Dijital rektal muayene, PI-RADS 3 lezyonu olan hastalarda prostat kanseri şüphesini ortaya koymak açısından pratik ve önemli bir parametredir.

Anahtar Kelimeler:

prostat kanseri, dijital rektal muayene, magnetik rezonans görüntüleme

Basic factors predicting prostate cancer in Prostate Imaging Reporting and Data System-3 lesions

Objective: We aimed to investigate the role of the digital rectal examination, PSA density, regional location of the lesion and prostate size in predicting prostate cancer in Prostate Imaging and Data Reporting System (PI-RADS)-3 lesions.Material and Methods: A total of 236 patients with multiparametric MRI performed for clinical suspicion of prostate cancer and reported PI-RADS-3 enrolled between January 2016 and July 2019 in this retrospective study. The datas were extracted from the hospital’s electronic records, patient files and outpatient clinic records. Multiparametric MRI was performed patients to whom have elevated PSA level and/or suspicious digital rectal examination. Patients diagnosed with and without prostate cancer were compared in terms of age, PSA, PSA density, prostate size, pathological results, lesion localization and DRE findings.Results: One hundred thirty- independent predictor seven patients with an initial score of PI-RADS-3 were subjected to further analysis. Prostat cancer detection rate in overall and clinically significant prostate cancer detection rate was 26.2% and 4.3%, respectively. There was a significant difference regarding DRE findings (p=0.001) and PZ location of the lesion (p=0.005) between PCa and no PCa groups. Digital rectal examination (p=0.001) was an independent predictor of prostate cancer in multivariate logistic regression analysis.Conclusion: Digital rectal examination is a practical and important parameter in clarifying the suspicion of prostate cancer in PI-RADS-3 lesions.

Keywords:

prostatic neoplasms digital rectal examination, multiparametric magnetic resonance imaging, image guided biopsy,

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