Roemeling Stijn, Roobol Monique J, Kattan Michael W, van der Kwast Theo H, Steyerberg Ewout W, Schröder Fritz H
Department of Urology, Erasmus MC, University Medical Center, Rotterdam, Netherlands.
Cancer. 2007 Nov 15;110(10):2218-21. doi: 10.1002/cncr.23029.
Screening for prostate cancer has resulted in an increased incidence-to-mortality ratio. Not all cancers deserve immediate treatment. It has therefore become more important to be able to identify those cases of screen-detected prostate cancer most likely to show indolent behavior.
The Kattan-nomogram for the prediction of indolent prostate cancer was validated and recalibrated for use in a screening setting. The recalibrated nomogram was used to calculate the number of men who were predicted to have indolent cancer in a screen-detected cohort from the European Randomized study of Screening for Prostate Cancer (ERSPC), section Rotterdam.
Of 1629 cancers detected in 2 subsequent screening rounds 825 were suitable for nomogram use. The remainder were very unlikely to have indolent cancer. A total of 485 men (485 of 825 = 59%) were predicted to have indolent cancer, which is 30% (485 of 1629) of all screen-detected cases. Cancers found at repeated screening after 4 years had a higher probability of indolent cancer than cases from the prevalence screening (44% vs 23%; P < .001).
The current nomogram can identify substantial groups of screen-detected cancers that are likely indolent and can therefore be considered for active surveillance.
前列腺癌筛查导致发病率与死亡率之比上升。并非所有癌症都需要立即治疗。因此，能够识别那些筛查发现的最有可能表现为惰性病程的前列腺癌病例变得更为重要。
对预测惰性前列腺癌的卡坦列线图进行验证和重新校准，以用于筛查环境。使用重新校准的列线图计算在欧洲前列腺癌筛查随机研究（ERSPC）鹿特丹分部的筛查队列中预计患有惰性癌的男性人数。
在随后两轮筛查中检测出的1629例癌症中，825例适合使用列线图。其余病例极不可能患有惰性癌。共有485名男性（825例中的485例 = 59%）预计患有惰性癌，占所有筛查发现病例的30%（1629例中的485例）。4年后重复筛查发现的癌症比初筛时发现的癌症更有可能是惰性癌（44% 对23%；P <.001）。
当前的列线图可以识别出大量筛查发现的可能为惰性的癌症病例，因此可考虑对其进行主动监测。
