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\u4fe1\u606f\u6765\u6e90 https:\/\/mp.weixin.qq.com\/s\/BvEnKJEnGdANE5N4Ta5xWg<\/p>\n

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Q1. \u8fd1\u5e74\u6765\uff0c\u524d\u5217\u817a\u764c\u8bca\u7597\u6b63\u4ece\u4f9d\u8d56\u4f20\u7edfPSA\u4e0e\u7cfb\u7edf\u6027\u7a7f\u523a\uff0c\u5411\u57fa\u4e8e\u591a\u7ec4\u5b66\u5206\u5b50\u5206\u578b\u3001PSMA\u9776\u5411\u5206\u5b50\u5f71\u50cf\u53ca\u6db2\u4f53\u6d3b\u68c0\u7684\u7cbe\u51c6\u8bca\u65ad\u6a21\u5f0f\u6f14\u8fdb\u3002\u4e34\u5e8a\u5b9e\u8df5\u4e2d\uff0c\u60a8\u8ba4\u4e3a\u54ea\u4e9b\u8bca\u65ad\u6280\u672f\u7684\u5f15\u5165\uff0c\u5bf9\u4f18\u5316\u540e\u7eed\u6cbb\u7597\u51b3\u7b56\u4ea7\u751f\u4e86\u6700\u4e3a\u5173\u952e\u7684\u5f71\u54cd\uff1f<\/strong><\/p>\n

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MDT\u6846\u67b6\u4e0b\u6cbb\u7597\u7b56\u7565\u6574\u5408\uff1a\u4ece\u201c\u5355\u6253\u72ec\u6597\u201d\u5230\u201c\u534f\u540c\u589e\u6548\u201d\u7684\u591a\u7ef4\u7a81\u7834<\/strong><\/p>\n

Q2. \u5728\u6cbb\u7597\u5c42\u9762\uff0c\u65e0\u8bba\u662f\u673a\u5668\u4eba\u8f85\u52a9\u624b\u672f\u7684\u4e0d\u65ad\u6539\u826f\uff0c\u653e\u5c04\u6cbb\u7597\u7684\u6781\u81f4\u5927\u5206\u5272\u4e0e\u591a\u6a21\u6001\u5f71\u50cf\u5f15\u5bfc\uff0c\u8fd8\u662f\u65b0\u578b\u5185\u5206\u6ccc\u6cbb\u7597\u9776\u5411\u6838\u7d20\u6cbb\u7597\u7684\u4e0d\u65ad\u6d8c\u73b0\uff0c\u5747\u4f53\u73b0\u4e86\u4ece\u201c\u5355\u7eaf\u6839\u6cbb\u75be\u75c5\u201d\u5230\u201c\u5168\u4eba\u5168\u7a0b\u7ba1\u7406\u201d\u7684\u7406\u5ff5\u8f6c\u53d8\u3002\u5728\u591a\u5b66\u79d1\u534f\u4f5c\uff08MDT\uff09\u6846\u67b6\u4e0b\uff0c\u8fd9\u4e9b\u521b\u65b0\u6280\u672f\u5982\u4f55\u8fdb\u884c\u6709\u673a\u6574\u5408\uff1f<\/strong><\/p>\n

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\u7b2c\u4e09\uff0c\u665a\u671f\u591a\u6a21\u6001\u8054\u5408\u4e0e\u9776\u5411\u6838\u7d20\u6cbb\u7597\u7684\u7cbe\u51c6\u6392\u5175\u5e03\u9635<\/strong>\u3002\u9488\u5bf9\u8f6c\u79fb\u6027\u53bb\u52bf\u654f\u611f\u6027\u524d\u5217\u817a\u764c\uff08mHSPC\uff09\u6216\u53bb\u52bf\u62b5\u6297\u6027\u524d\u5217\u817a\u764c\uff08mCRPC\uff09\uff0cMDT\u7684\u4f5c\u7528\u5728\u4e8e\u89c4\u5212\u6cbb\u7597\u7b56\u7565\u3002\u4f4e\u7624\u8d1f\u8377\/\u4f4e\u98ce\u9669\u7684mHSPC\u60a3\u8005\u53ef\u9009\u62e9ADT+NHT\u7684\u201c\u4e8c\u8054\u7597\u6cd5\u201d\u6216\u201c\u4e09\u8054\u7597\u6cd5\u201d\uff0c\u9ad8\u7624\u8d1f\u8377mHSPC\u60a3\u8005\u5e94\u4f18\u5148\u91c7\u7528ADT+NHT+\u591a\u897f\u4ed6\u8d5b\u7684\u201c\u4e09\u8054\u7597\u6cd5\u201d\u3002mCRPC\u60a3\u8005\u5177\u6709\u8f83\u9ad8\u7684\u5206\u5b50\u5f02\u8d28\u6027\uff0c\u56e0\u6b64\u9700\u8981\u901a\u8fc7\u7cbe\u51c6\u5206\u5b50\u5206\u578b\u5c06\u60a3\u8005\u5206\u4e3a\u4e0d\u540c\u4eba\u7fa4\uff0c\u9010\u4e2a\u5236\u5b9a\u4e2a\u4f53\u5316\u6cbb\u7597\u65b9\u6848\uff1a\u9488\u5bf9\u4f34\u6709\u540c\u6e90\u91cd\u7ec4\u4fee\u590d\uff08HRR\uff09\/BRCA1\/2\u7a81\u53d8\u7684\u60a3\u8005\u7cbe\u51c6\u5f15\u5165PARP\u6291\u5236\u5242[8]<\/sup>\uff1b\u5bf9\u4e8e\u65e2\u5f80\u672a\u7ecfNHT\u3001\u65e0HRR\u7a81\u53d8\u7684mCRPC\u60a3\u8005\uff0c\u5728\u7ef4\u6301ADT\u7684\u57fa\u7840\u4e0a\uff0c\u53ef\u8003\u8651\u8054\u5408NHT\u3002<\/p>\n

\u7b2c\u56db\uff0c\u665a\u671f\u60a3\u8005\u9aa8\u8f6c\u79fb\u7ba1\u7406\u7684\u521b\u65b0\u8f6c\u53d8<\/strong>\u3002\u524d\u5217\u817a\u764c\u5177\u6709\u6781\u9ad8\u7684\u9aa8\u55dc\u6027\uff0c\u9aa8\u8f6c\u79fb\u7ba1\u7406\u662f\u5168\u7a0b\u7ba1\u7406\u4e2d\u7684\u5173\u952e\u73af\u8282\u3002\u9aa8\u8f6c\u79fb\u4e00\u7ecf\u786e\u8bca\u5373\u5e94\u5c3d\u65e9\u3001\u89c4\u8303\u5e94\u7528\u9aa8\u9776\u5411\u836f\u7269\u3002\u9aa8\u9776\u5411\u836f\u7269\uff08\u5982\u5730\u8212\u5355\u6297\uff09\u7684\u89d2\u8272\u5df2\u4ece\u5355\u7eaf\u9884\u9632\u9aa8\u76f8\u5173\u4e8b\u4ef6\uff08SREs\uff09\u7684\u5bf9\u75c7\u6cbb\u7597\u836f\u7269\uff0c\u8f6c\u53d8\u4e3a\u7cfb\u7edf\u6cbb\u7597\u65b9\u6848\u4e2d\u7684\u201c\u534f\u540c\u589e\u6548\u4f19\u4f34\u201d[9]<\/sup>\u3002\u9aa8\u9776\u5411\u836f\u7269\u4e0d\u4ec5\u80fd\u6709\u6548\u964d\u4f4e\u75c5\u7406\u6027\u9aa8\u6298\u3001\u810a\u9ad3\u538b\u8feb\u7b49SREs\u53d1\u751f\u98ce\u9669\uff0c\u66f4\u91cd\u8981\u7684\u662f\u80fd\u6539\u5584\u9aa8\u5fae\u73af\u5883\u3002\u8fd9\u79cd\u5c40\u90e8\u4fdd\u62a4\u4f5c\u7528\u4e0eNHT\u3001\u653e\u7597\u6216\u9776\u5411\u6838\u7d20\u6cbb\u7597\uff08\u5982\u956d-223\uff09\u8054\u5408\u4f7f\u7528\uff0c\u5177\u6709\u663e\u8457\u7684\u534f\u540c\u83b7\u76ca\uff0c\u80fd\u66f4\u5168\u9762\u5730\u63d0\u5347\u60a3\u8005\u7684\u6574\u4f53\u9884\u540e\u53ca\u751f\u6d3b\u8d28\u91cf[10]<\/sup>\u3002<\/p>\n

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Q3. \u5c55\u671b\u672a\u6765\uff0c\u60a8\u8ba4\u4e3a\u524d\u5217\u817a\u764c\u4e34\u5e8a\u521b\u65b0\u6700\u5e94\u4f18\u5148\u7a81\u7834\u7684\u74f6\u9888\u6216\u6700\u5177\u53d8\u9769\u6f5c\u529b\u7684\u65b9\u5411\u662f\u4ec0\u4e48\uff0c\u4ee5\u771f\u6b63\u5b9e\u73b0\u533b\u7597\u8d28\u91cf\u540c\u8d28\u5316\u4e0e\u60a3\u8005\u751f\u5b58-\u751f\u6d3b\u8d28\u91cf\u53cc\u63d0\u5347\u7684\u7ec8\u6781\u76ee\u6807\uff1f<\/strong><\/p>\n

\u6768\u6625\u5149\u6559\u6388\uff1a<\/strong>\u5c55\u671b\u672a\u6765\uff0c\u6211\u8ba4\u4e3a\u524d\u5217\u817a\u764c\u8bca\u7597\u7684\u53d8\u9769\u5c06\u805a\u7126\u4e8e\u667a\u80fd\u5316\u3001\u7cbe\u51c6\u5316\u53ca\u5fae\u521b\u5316\u4e09\u4e2a\u7ef4\u5ea6\u3002<\/p>\n

\u9996\u5148\u662fAI\u8f85\u52a9\u7684\u7cbe\u51c6\u51b3\u7b56\u7cfb\u7edf\uff08\u667a\u80fd\u5316\uff09<\/strong>\u3002\u76ee\u524d\u5916\u79d1\u624b\u672f\u7684\u7ed3\u5c40\u4f9d\u7136\u5728\u4e00\u5b9a\u7a0b\u5ea6\u4e0a\u4f9d\u8d56\u4e8e\u672f\u8005\u7ecf\u9a8c\u3002\u672a\u67653-5\u5e74\uff0cAI\u5c06\u4e0d\u4ec5\u9650\u4e8e\u9605\u7247\uff0c\u800c\u662f\u901a\u8fc7\u6574\u5408\u591a\u6a21\u6001\u5f71\u50cf\u3001\u75c5\u7406\u5b66\u7279\u5f81\u53ca\u9057\u4f20\u4fe1\u606f\uff0c\u6784\u5efa\u5168\u751f\u547d\u5468\u671f\u7684\u98ce\u9669\u9884\u6d4b\u6a21\u578b\u3002\u672f\u4e2d\u7ed3\u5408\u589e\u5f3a\u73b0\u5b9e\uff08AR\/VR\uff09\u4e0e\u5432\u54da\u83c1\u7eff\uff08ICG\uff09\u8367\u5149\u5f15\u5bfc\u6280\u672f\uff0c\u5c06\u80bf\u7624\u8fb9\u754c\u4e0e\u795e\u7ecf\u8840\u7ba1\u7f51\u5b9e\u65f6\u4e09\u7ef4\u6295\u5f71\u4e8e\u673a\u68b0\u81c2\u89c6\u91ce\u4e2d\u3002\u8fd9\u79cd\u667a\u80fd\u8f85\u52a9\u7cfb\u7edf\u4e0d\u4ec5\u80fd\u663e\u8457\u964d\u4f4e\u5207\u7f18\u9633\u6027\u7387\uff0c\u66f4\u80fd\u6253\u7834\u5b66\u4e60<\/span>\u66f2\u7ebf\u7684\u58c1\u5792\uff0c\u771f\u6b63\u63a8\u52a8\u9ad8\u96be\u5ea6\u5fae\u521b\u624b\u672f\u5728\u4e0d\u540c\u533a\u57df\u548c\u5c42\u7ea7\u533b\u9662\u95f4\u7684\u8d28\u91cf\u540c\u8d28\u5316[11]<\/sup>\u3002<\/p>\n

\u5176\u6b21\u662f\u57fa\u4e8e\u8010\u836f\u673a\u5236\u548c\u5fae\u5c0f\u6b8b\u7559\u75c5\u7076\uff08MRD\uff09\u7684\u7cbe\u51c6\u6cbb\u7597\u65b9\u6848\u5236\u5b9a\uff08\u7cbe\u51c6\u5316\uff09<\/strong>\u3002\u968f\u7740\u5bf9\u96c4\u6fc0\u7d20\u53d7\u4f53\uff08AR\uff09\u4fe1\u53f7\u901a\u8def\u53ca\u80bf\u7624\u514d\u75ab\u5fae\u73af\u5883\u7406\u89e3\u7684\u52a0\u6df1\uff0c\u9488\u5bf9\u7279\u5b9a\u7a81\u53d8\uff08\u5982PTEN\u3001BRCA\u3001ATM\u7b49\uff09\u7684\u9776\u5411\u836f\u7269\u4ee5\u53ca\u521b\u65b0\u7684\u514d\u75ab\u8054\u5408\u7597\u6cd5\u5c06\u4e0d\u65ad\u6d8c\u73b0\u3002\u5c24\u5176\u662f\u9488\u5bf9CRPC\u9636\u6bb5\u7684\u4e2a\u6027\u5316\u65b9\u6848\uff0c\u5c06\u8fdb\u4e00\u6b65\u5ef6\u957f\u60a3\u8005\u7684\u65e0\u8fdb\u5c55\u751f\u5b58\u671f[5]<\/sup>\u3002\u6b64\u5916\uff0c\u5f53\u524d\u56f4\u624b\u672f\u671f\u8f85\u52a9\u6cbb\u7597\u591a\u57fa\u4e8e\u7fa4\u4f53\u6982\u7387\uff0c\u5bb9\u6613\u5bfc\u81f4\u8fc7\u5ea6\u6cbb\u7597\u3002\u672a\u67653-5\u5e74\u4e9f\u9700\u901a\u8fc7\u5b9e\u65f6\u52a8\u6001\u76d1\u6d4b\u672f\u540eMRD\u72b6\u6001\uff0c\u7cbe\u51c6\u7b5b\u9009\u51fa\u9700\u8981\u65e9\u671f\u5f3a\u5316\u6cbb\u7597\u7684\u9ad8\u5371\u60a3\u8005\uff0c\u540c\u65f6\u8ba9ctDNA\u9634\u6027\u7684\u60a3\u8005\u5b89\u5168\u514d\u9664\u4e0d\u5fc5\u8981\u7684\u8f85\u52a9\u653e\u7597\u6216\u5185\u5206\u6ccc\u6bd2\u6027\uff0c\u5b9e\u73b0\u7cbe\u51c6\u7684\u8f85\u52a9\u6cbb\u7597”\u5347\/\u964d\u9636”\u95ed\u73af\u3002<\/p>\n

\u6700\u540e\u662f\u5c40\u7076\u6cbb\u7597\u4e0e\u5fae\u521b\u6280\u672f\u7684\u6781\u7b80\u63a2\u7d22\uff08\u5fae\u521b\u5316\uff09<\/strong>\u3002\u4e3a\u4e86\u8ffd\u6c42\u6781\u81f4\u7684\u751f\u6d3b\u8d28\u91cf\uff0c\u5982\u4f55\u5c06\u6cbb\u7597\u521b\u4f24\u964d\u81f3\u6700\u4f4e\u662f\u6c38\u6052\u7684\u8bfe\u9898\u3002\u9488\u5bf9\u90e8\u5206\u7ecf\u4e25\u683c\u7b5b\u9009\u3001\u75c5\u7076\u6bd4\u8f83\u5c40\u9650\u7684\u60a3\u8005\uff0c\u672a\u6765\u7684\u7814\u7a76\u91cd\u70b9\u5728\u4e8e\u5982\u4f55\u901a\u8fc7\u9ad8\u80fd\u805a\u7126\u8d85\u58f0\uff08HIFU\uff09\u6216\u51b7\u51bb\u6d88\u878d\u7b49\u5c40\u7076\u6cbb\u7597\u624b\u6bb5\uff0c\u5728\u8fbe\u5230\u80bf\u7624\u5b66\u63a7\u5236\u7684\u540c\u65f6\uff0c\u5c3d\u53ef\u80fd\u5b9e\u73b0\u201c\u96f6\u521b\u4f24\u201d\u5f0f\u7684\u529f\u80fd\u4fdd\u7559\uff0c\u4f7f\u60a3\u8005\u5728\u4e0d\u727a\u7272\u751f\u6d3b\u8d28\u91cf\u7684\u524d\u63d0\u4e0b\u83b7\u5f97\u957f\u671f\u751f\u5b58[12]<\/sup>\u3002<\/p>\n

<\/p>\n

\u6768\u6625\u5149\uff0c\u540c\u6d4e\u533b\u9662\u6ccc\u5c3f\u5916\u79d1\u4e3b\u4efb\u533b\u5e08\uff0c\u526f\u6559\u6388\uff0c\u524d\u5217\u817a\u764c\u5355\u75c5\u79cd\u533b\u7597\u7ec4\u7ec4\u957f\uff0cCSCO\u524d\u5217\u817a\u764c\u4e13\u59d4\u4f1a\u59d4\u5458\uff0c\u4e2d\u534e\u533b\u5b66\u4f1a\u6ccc\u5c3f\u5916\u79d1\u5206\u4f1a\u667a\u6167\u5916\u79d1\u5b66\u7ec4\u59d4\u5458\uff0c\u4eba\u6c11\u597d\u533b\u751f.\u91d1\u5c71\u8336\u82b1\u8ba1\u5212\u6ccc\u5c3f\u80bf\u7624\u9886\u57df\u4f18\u79c0\u5178\u8303\u3002<\/section>\n

\u53c2\u8003\u6587\u732e<\/strong><\/p>\n

[1] Rouvi\u00e8re O, Puech P, Renard-Penna R, et al. Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study[J]. Lancet Oncol, 2019, 20(1): 100-109.<\/p>\n

[2] \u4e2d\u56fd\u6297\u764c\u534f\u4f1a\u7537\u6027\u751f\u6b96\u7cfb\u7edf\u80bf\u7624\u4e13\u4e1a\u59d4\u5458\u4f1a. \u524d\u5217\u817a\u764c\u5168\u7a0b\u7ba1\u7406\u4e13\u5bb6\u5171\u8bc6(2025\u7248)[J]. \u4e2d\u534e\u80bf\u7624\u6742\u5fd7, 2025, 47(7): 533-550.<\/p>\n

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[9] \u4e2d\u534e\u533b\u5b66\u4f1a\u6ccc\u5c3f\u5916\u79d1\u5b66\u5206\u4f1a. \u4e2d\u56fd\u524d\u5217\u817a\u764c\u9aa8\u8f6c\u79fb\u8bca\u7597\u73b0\u72b6\uff08\u84dd\u76ae\u4e66\uff09[J]. \u4e2d\u534e\u6ccc\u5c3f\u5916\u79d1\u6742\u5fd7, 2025, 46(11): 801-815.<\/p>\n

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