Öz
Amaç:
Bu çalışma, prostat kanseri şüphesi olan biyopsi olmamış hastalarda prostat kanseri ve klinik anlamlı prostat kanserini öngörmede De Ritis oranının (DRR) tanısal değerini değerlendirmeyi amaçlamaktadır.
Yöntem:
Ocak 2015 ile Temmuz 2019 arasında transrektal ultrason eşliğinde prostat iğne biyopsisi (TRUS-Bx) yapılan 282 erkek hastanın tıbbi kayıtlarını retrospektif olarak inceledik. Hastaların parmakla rektal muayene bulguları, biyopsi öncesi prostat spesifik antijen (PSA), aspartat aminotransferaz ve alanin aminotransferaz düzeyleri, prostat hacmi, komorbiditeleri ve TRUS-Bx örneklerine ait patolojik bulgularını içeren demografik ve klinik özellikler her hasta için ayrıntılı olarak not edildi. Çalışma grubu, TRUS-Bx örneklerinin histopatolojik sonuçlarına göre iki gruba ayrıldı (grup 1: benign patolojili hastalar, grup 2: prostat kanseri hastaları). Prostat kanserini öngörmede PSA, PSA dansitesi ve De Ritis oranının tanısal performansını değerlendirmek için ROC eğrisi analizi yapıldı.
Bulgular:
Hastaların ortanca yaşı 64 (59-69) yıl idi. Hastaların %71,6’sı (n=202) grup 1’de, %28,4’ü (n=80) grup 2’de yer aldı. Grup 1’deki DRR’nin ortanca değeri 1,08 (aralık: 0,89-1,32) ve grup 2’nin ortanca DRR değeri 1,19 (aralık: 0,95-1,56) olarak belirlendi. Grup 2 DRR medyan değeri grup 1’den istatistiksel olarak anlamlı olarak daha yüksek bulundu (p=0,013). TRUS-Bx örneklerinde prostat kanseri ile DRR arasında istatistiksel olarak anlamlı ancak zayıf bir pozitif korelasyon gözlendi (r=0,149, p=0,012). Buna karşın TRUS-Bx örneklerindeki klinik anlamlı prostat kanseri ile DRR arasında istatistiksel olarak anlamlı bir korelasyon yoktu (r=0,002, p=0,983). ROC eğrisi analizi, TRUS-Bx örneklerinde prostat kanseri varlığı için DRR’nin eşik değerinin 1,125 olduğunu gösterdi ve eğri altındaki alan 0,595 (%95 güven aralığı=0,518-0,672, p=0,013) idi.
Sonuç:
Bu çalışma, De Ritis oranının, transrektal prostat biyopsisi uygulanan biyopsi-naive hastalarda prostat kanserini öngörmede kısıtlı bir tanısal değeri olduğunu göstermektedir.
Anahtar Kelimeler: Alanin aminotransferaz, aspartat aminotransferaz, De Ritis oranı, prostat kanseri
Kaynakça
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