孟广明,栗海龙

前列腺癌是男性生殖系统最常见的恶性肿瘤之一，其发病率在全球男性恶性肿瘤中位居第二，在我国呈逐年上升且年轻化的趋势。PCa诊疗过程中存在早期诊断敏感性不足、分期精准度欠佳、疗效评估滞后及预后预测缺乏个体化指标等问题。磁共振成像（MRI）凭借其多参数成像优势已成为PCa诊疗的核心影像手段，而影像组学技术可从MRI图像中挖掘海量定量特征，结合临床常规指标构建整合模型，为PCa的精准诊疗提供新路径。本文系统梳理近年来MRI影像组学结合临床特征指标在PCa早期诊断与筛查、肿瘤分期及危险度分层、治疗方案优化与疗效评估、预后预测等方面的研究进展，分析该整合策略的优势与现存瓶颈，并对其未来发展趋势进行展望，为临床规范化应用及后续研究提供参考。

MRI影像组学；临床特征；前列腺癌；精准诊疗；疗效评估；预后预测

[1] 艾俊宇,杨德林.前列腺癌关键基因诊疗策略的前沿进展[J].中国现代医生,2025,63(09):118-122. [2] 朱涵菁,董樑,赵斌,等.基于创新性慢性病照护框架的前列腺癌早筛早诊模式探索[J].中华男科学杂志,2025,31(03):229-233. [3] Wairiri L,Folkert R M.Treatment-Response Prediction for Metastatic Castrate-Resistant Prostate Cancer Using PSMA PET.[J]. Radiology.Imaging cancer,2025,7(6):e259030. [4] Yuan L,Zhang J,Ma L,et al.MRI-based Habitat Imaging for Noninvasive Prediction of High-Grade Prostate Cancer.[J].Radiology. Imaging cancer,2025,7(6):e240395. [5] Liepe K,Hoang M T,Baehr M.The diagnostic accuracy of[99mTc]Tc-PSMA SPECT/CT for recurrent prostate cancer based on individual patient attributes.[J].European journal of nuclear medicine and molecular imaging,2025, [6] Widjaja L,Hornfeck J,Siegmund C S,et al.Refining the clinical utility of[177Lu]Lu/[225Ac]Ac-PSMA tandem RLT in patients with metastatic castration resistant prostate cancer.[J].European journal of nuclear medicine and molecular imaging,2025, [7] Freedland J S,Ramaswamy K,Kavati A,et al.Retrospective Analysis of Racial Differences in Treatment Patterns and Prostate-Specific Antigen Responses Among Patients with Prostate Cancer Treated with Relugolix in the Veterans Health Administration.[J].Advances in therapy,2025, [8] Abdelwehab S I,Sluzar P,MacAskill F,et al.Early low-intensity extracorporeal shockwave therapy for the preservation and restoration of erectile function after nerve-sparing radical prostatectomy:interim safety assessment.[J].The journal of sexual medicine,2025, [9] Lepor H,Thakker S,Rapoport E,et al.Factors predicting sexual function dissatisfaction following primary partial gland cryoablation. [J].The journal of sexual medicine,2025,DOI:10.1093/JSXMED/QDAF289. [10] Ogaili A M,Venkatesh A,Dham J,et al.The impact of internal iliac artery clamping on blood loss,functional outcomes,and cancer control during robotic-assisted radical prostatectomy.[J].Journal of robotic surgery,2025,19(1):735. [11] Franz T,Sicker T,Lueke J,et al.To biopsy or not biopsy,that is the question-PI-RADS 3 prostate lesions-validation of clinical and radiological parameters for biopsy decision-making.[J].BMC urology,2025,25(1):274. [12] Liu A M,Raghunathan R,Runcie K,et al.Association between medication burden and acute care use in older metastatic prostate cancer patients on androgen receptor signaling inhibitors.[J].Cancer,2025,131(21):e70163. [13] O’Reilly M,McDermott R.CYCLONE 2:no impact on prostate cancer forecast[J].The Lancet Oncology,2025,26(11):1400-1402. [14] Smith M,Piulats J,Todenhöfer T,et al.Abemaciclib plus abiraterone in patients with metastatic castration-resistant prostate cancer(CYCLONE 2):a randomised,double-blind,placebo-controlled,phase 3 trial[J].The Lancet Oncology,2025,26(11):1489-1500. [15] Rathi A,Qais A F,Rashid N,et al.Identification and In Silico Characterization of an Alternatively Spliced Novel Transcript of Human DDR2 Gene[J].Cell Biochemistry and Biophysics,2025,(prepublish):1-15. [16] Yu Y E,Suzuki H,Pieczonka M C,et al.DARolutamide ObservationaL(DAROL)study in patients with nonmetastatic castration-resistant prostate cancer:prespecified third interim analysis[J].Prostate Cancer and Prostatic Diseases,2025,(prepublish):1-4. [17] Gogebakan C K,Elsisi Z,Campos M F,et al.Prostate-specific membrane antigen positron emission tomography/computed tomography imaging as a precision diagnostic at prostate cancer recurrence after radical prostatectomy:Modeling long-term survival.[J].Cancer, 2025,131(21):e70131. [18] Sim H,Bae S,Park W C,et al.Lipid Metabolic Reprogramming During Progression to Castration-resistant Prostate Cancer Identified by Quantitative Proteomics.[J].Cancer genomics&proteomics,2025,22(6):940-952. [19] Kim Y J,Sim H,Na Y A,et al.Global Profiling of Lysine Lactylation in Prostate Cancer Cells.[J].Cancer genomics&proteomics, 2025,22(6):929-939. [20] 孙明伟,郭鹏宇,徐万海.泌尿系统肿瘤分子探针精准诊疗的创新与挑战[J].肿瘤防治研究,2025,52(10):811-817. [21] Gogebakan C K,Elsisi Z,Campos M F,et al.Prostate-specific membrane antigen positron emission tomography/computed tomography imaging as a precision diagnostic at prostate cancer recurrence after radical prostatectomy:Modeling long-term survival.[J].Cancer, 2025,131(21):e70131. [22] 朱虹,汪会,司宏伟,等.靶向前列腺特异性膜抗原含脲类PET显像剂的研究进展[J/OL].安徽医科大学学报,1-12[2025-11-05]. [23] 邓文杰,唐旭,张志源,等.循环肿瘤DNA液体活检在前列腺癌诊疗中的应用进展[J].大医生,2025,10(18):121-124. [24] 唐太松,吴丽霞,杨富辉.MRI影像组学在前列腺癌诊疗中的研究进展[J].实用放射学杂志,2025,41(09):1562-1565. [25] 杜慧娟,王保军,李娟,等.前列腺癌全程管理中的共同决策:改善患者结局和医生技能的学习曲线分析[J].微创泌尿外科杂志, 2025,14(04):269-276. [26] 刘浩然,谭智勇,黄应龙,等.影像组学在前列腺癌诊疗中的研究进展[J].临床泌尿外科杂志,2025,40(07):661-665. [27] 许华,沈祐民,戴波.年轻前列腺癌根治术患者临床病理特点与生化复发风险研究[J].临床泌尿外科杂志,2025,40(06):509-513. [28] 刘志轩.基于多参数MRI影像组学预测前列腺癌侵袭性:Gleason分级分组､神经侵犯和Ki-67表达的综合评估[D].南昌大学,2025. [29] 谢婷,顾涛.前列腺特异性抗原及其衍生指标在前列腺癌诊疗中的研究进展[J].现代养生,2025,25(08):564-567. [30] 刘灵珍.多学科诊疗护理模式在前列腺癌根治术后患者控尿功能中的价值分析[J].中国冶金工业医学杂志,2025,42(02):161-162.

点击下载PDF