Comparison Of MpMRI/TRUS Fusion Guided Biopsy With Systematic Biopsy For The Diagnosis Of Prostate Cancer:A Meta-analysis

Objectives:Comparison of mpMRI-TRUS fusion targeted biospy and systematic prostate biospy in the diagnosis of prostate cancer positive rate,in order to improve the accuracy of prostate cancer diagnosis.Methods:By searching domestic and foreign databases,Chinese databases include: CBM,CNKI,Wanfang,and Weipu;Foreign databases include PubMed,Medline,and Web of science.The period is from the database of beging to March 2018,and manually search for related magazines,including RCT,controlled clinical trials or case-control studies.According to the strict exclusion and inclusion criteria.Finally,RevMan 5.3software was used to perform meta-analysis of the extracted data.The outcome were the detection of clinically significant prostate cancer,and the detection of any cancer.Results:13 studies were brought after searching the database,including one RCT and 12 case controlled trials.A total of 2431 cases were included in the study.The result indicated that use of mpMRI-TRUS fusion can detectet the greater numbers prostate cancers compared with systematic prostate biospy,no matter in the detection of clinically significant prostate cancer or any cancer.The detection of any cancer was48.0%(1168/2431)for the mpMRI-TRUS and 44.7%(1085/2430)for the systematic prostate biopsy;the OR was 1.15(95% CI 1.03~1.29 P=0.02).The detection of clinically significant disease was 32.6%(753/2313)for the mpMRI-TRUS and26.4%(612/2316)for the systematic prostate biopsy,.the OR was 1.37(95% CI1.20~1.56,P<0.00001).Both groups had statistically significant results.In the missed rate of prostate cancer,there was no significant difference in the rate of missed diagnosis of mpMRI-TRUS fusion targeted biospy and systematic prostate biospy in total prostate cancer,with an OR of 0.75(95% CI 0.52 to 1.08,P=0.12);However mpMRI-TRUS fusion targeted biospy had less clinically significant missed rates of prostate cancer than systematic prostate biospy,with an OR of 0.35(95% CI 0.24 to0.52,Z=5.46 P<0.00001).Conclusion:Compared with systematic prostate biopsy,mpMRI-TRUS fusion targeted biopsy can increase the positive rate of prostate cancer diagnosis,in particular the positive rate of clinically significant prostate cancer.