Abstract：
Surgery for benign prostatic hyperplasia (BPH) has greatly advanced with the development of laser technology ; and holmium laser enucleation of the prostate (HoLEP), which can be performed safely and with minimal invasiveness regardless of prostate size. Incidental prostate carcinoma (iPCa) following HoLEP occurs at a certain rate. Predictors, include age, biopsy, history, preoperative prostate specific antigen, and prostate volume. We compared cases with and without incidental carcinoma detection among 257 patients with BPH who underwent HoLEP at our hospital from July 2015 to December 2022. Among the 257 patients, 29 (11.3%) were found to have incidental carcinoma. Although 1 patient switched to endocrine therapy the remaining patients showed good prognosis under surveillance therapy. The proportion of cases with magnetic resonance imaging (MRI) findings suggestive of carcinoma was significantly higher in the incidental carcinoma detection group (p＝0.009). Furthermore, univariate analysis of incidental carcinoma predictive factors revealed a significant difference in MRI findings (odds ratio [OR] 2.92 ; confidence interval [CI] 1.33-6.42), and multivariate analysis showed similar results (OR 2.92 ; CI 1.33-6.42). At our hospital, we currently perform MRI scans for preoperative morphological assessments but not for cancer diagnosis. However, based on the results obtained, we aim to proactively utilize MRI for preoperative malignant screening, in addition to PSA.
摘要：
随着激光技术的发展，良性前列腺增生（BPH）的手术有了很大的进步；钬激光前列腺摘除术（HoLEP），无论前列腺大小如何，都可以安全且具有最小的侵入性。HoLEP后偶发前列腺癌（iPCa）的发生率一定。预测器,包括年龄,活检,历史,术前前列腺特异性抗原，和前列腺体积。我们比较了2015年7月至2022年12月在我们医院接受HoLEP的257例BPH患者中有无偶发癌的病例。在257名患者中，发现29例（11.3％）患有偶发癌。尽管有1例患者改用内分泌治疗，但其余患者在监测治疗下预后良好。偶发癌组磁共振成像（MRI）表现提示癌的病例比例明显高于偶发癌组（p＝0.009）。此外，偶发癌预测因素的单因素分析显示，MRI表现存在显着差异（比值比[OR]2.92；置信区间[CI]1.33-6.42），和多变量分析显示相似的结果（OR2.92；CI1.33-6.42）。在我们的医院,我们目前进行MRI扫描用于术前形态学评估,但不用于癌症诊断.然而,根据获得的结果，我们的目标是积极利用MRI进行术前恶性筛查，除了PSA。
