Optimizing the clinical utility of PCA3 to diagnose prostate cancer in initial prostate biopsy.
Background: PCA3 has been included in a nomogram outperforming previous clinical models for the prediction of any prostate cancer (PCa) and high grade PCa (HGPCa) at the initial prostate biopsy (IBx). Our objective is to validate such IBx-specific PCA3-based nomogram. We also aim to optimize the use...
| Publicado en: | BMC Cancer Vol. 15; no. 1; pp. 1 - 9 |
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| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
BioMed Central
9/12/2015
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109517459&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109517459 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712407 1CH9 jtl: BMC Cancer issn: 14712407 maglogo: N pubinfo: dt: 9/12/2015 vid: 15 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 109517459 109517459 NLM26362197 109517459 10.1186/s12885-015-1623-0 NLM26362197 PMC4567811 109517459 ppf: 1 ppct: 8 formats: tig: atl: Optimizing the clinical utility of PCA3 to diagnose prostate cancer in initial prostate biopsy. aug: au: Rubio-Briones, Jose Borque, Angel Esteban, Luis M. Casanova, Juan Fernandez-Serra, Antonio Rubio, Luis Casanova-Salas, Irene Sanz, Gerardo Domínguez-Escrig, Jose Collado, Argimiro Gómez-Ferrer, Alvaro Iborra, Inmaculada Ramírez-Backhaus, Miguel Martínez, Francisco Calatrava, Ana Lopez-Guerrero, Jose A. affil: Department of Urology, Instituto Valenciano de Oncología, C/Prof. Beltrán Báguena 8, 46009 Valencia, Spain sug: subj: Prostatic Neoplasms Metabolism Antigens, Tumor Metabolism Prostatic Neoplasms Diagnosis Risk Assessment Methods Models, Statistical Decision Support Techniques Aged Body Weights and Measures Biopsy Male Middle Age Prospective Studies Risk Factors Validation Studies Comparative Studies Evaluation Research Multicenter Studies Human Aged: 65+ years Middle Aged: 45-64 years Male ab: Background: PCA3 has been included in a nomogram outperforming previous clinical models for the prediction of any prostate cancer (PCa) and high grade PCa (HGPCa) at the initial prostate biopsy (IBx). Our objective is to validate such IBx-specific PCA3-based nomogram. We also aim to optimize the use of this nomogram in clinical practice through the definition of risk groups.Methods: Independent external validation. Clinical and biopsy data from a contemporary cohort of 401 men with the same inclusion criteria to those used to build up the reference's nomogram in IBx. The predictive value of the nomogram was assessed by means of calibration curves and discrimination ability through the area under the curve (AUC). Clinical utility of the nomogram was analyzed by choosing thresholds points that minimize the overlapping between probability density functions (PDF) in PCa and no PCa and HGPCa and no HGPCa groups, and net benefit was assessed by decision curves.Results: We detect 28% of PCa and 11 % of HGPCa in IBx, contrasting to the 46 and 20% at the reference series. Due to this, there is an overestimation of the nomogram probabilities shown in the calibration curve for PCa. The AUC values are 0.736 for PCa (C.I.95%:0.68-0.79) and 0.786 for HGPCa (C.I.95%:0.71-0.87) showing an adequate discrimination ability. PDF show differences in the distributions of nomogram probabilities in PCa and not PCa patient groups. A minimization of the overlapping between these curves confirms the threshold probability of harboring PCa >30 % proposed by Hansen is useful to indicate a IBx, but a cut-off > 40% could be better in series of opportunistic screening like ours. Similar results appear in HGPCa analysis. The decision curve also shows a net benefit of 6.31% for the threshold probability of 40%.Conclusions: PCA3 is an useful tool to select patients for IBx. Patients with a calculated probability of having PCa over 40% should be counseled to undergo an IBx if opportunistic screening is required. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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