Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Changhai Road 168, Yangpu District, Shanghai, 200433, China.
Department of Urology, Erasmus University Medical Center, Room Na1706, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
World J Urol. 2021 Jan;39(1):73-80. doi: 10.1007/s00345-020-03177-0. Epub 2020 Apr 11.
To externally validate the clinical utility of Chinese Prostate Cancer Consortium Risk Calculator (CPCC-RC) and Asian adapted Rotterdam European Randomized Study of Screening for Prostate Cancer Risk Calculator 3 (A-ERSPC-RC3) for prediction prostate cancer (PCa) and high-grade prostate cancer (HGPCa, Gleason Score ≥ 3 + 4) in both Chinese and European populations.
The Chinese clinical cohort, the European population-based screening cohort, and the European clinical cohort included 2,508, 3,616 and 617 prostate biopsy-naive men, respectively. The area under the receiver operating characteristic curve (AUC), calibration plot and decision curve analyses were applied in the analysis.
The CPCC-RC's predictive ability for any PCa (AUC 0.77, 95% CI 0.75-0.79) was lower than the A-ERSPC-RC3 (AUC 0.79, 95% CI 0.77-0.81) in the European screening cohort (p < 0.001), but similar for HGPCa (p = 0.24). The CPCC-RC showed lower predictive accuracy for any PCa (AUC 0.65, 95% CI 0.61-0.70), but acceptable predictive accuracy for HGPCa (AUC 0.73, 95% CI 0.69-0.77) in the European clinical cohort. The A-ERSPC-RC3 showed an AUC of 0.74 (95% CI 0.72-0.76) in predicting any PCa, and a similar AUC of 0.74 (95% CI 0.72-0.76) in predicting HGPCa in Chinese cohort. In the Chinese population, decision curve analysis revealed a higher net benefit for CPCC-RC than A-ERSPC-RC3, while in the European screening and clinical cohorts, the net benefit was higher for A-ERSPC-RC3.
The A-ERSPC-RC3 accurately predict the prostate biopsy in a contemporary Chinese multi-center clinical cohort. The CPCC-RC can predict accurately in a population-based screening cohort, but not in the European clinical cohort.
验证中国前列腺癌联盟风险计算器（CPCC-RC）和亚洲改良鹿特丹欧洲前列腺癌筛查风险计算器 3（A-ERSPC-RC3）在预测中国和欧洲人群前列腺癌（PCa）和高级别前列腺癌（HGPCa，Gleason 评分≥3+4）方面的临床应用价值。
纳入了 2508 名中国临床队列、3616 名欧洲人群筛查队列和 617 名欧洲临床队列的前列腺活检初筛男性。应用受试者工作特征曲线下面积（AUC）、校准图和决策曲线分析来评估。
CPCC-RC 在欧洲筛查队列中的预测任何 PCa 的能力（AUC 0.77，95%CI 0.75-0.79）低于 A-ERSPC-RC3（AUC 0.79，95%CI 0.77-0.81）（p<0.001），但在预测 HGPCa 方面无显著差异（p=0.24）。CPCC-RC 在欧洲临床队列中预测任何 PCa 的准确性较低（AUC 0.65，95%CI 0.61-0.70），但预测 HGPCa 的准确性尚可（AUC 0.73，95%CI 0.69-0.77）。A-ERSPC-RC3 在中国人群中预测任何 PCa 的 AUC 为 0.74（95%CI 0.72-0.76），预测 HGPCa 的 AUC 也为 0.74（95%CI 0.72-0.76）。在中国人群中，决策曲线分析显示 CPCC-RC 的净获益高于 A-ERSPC-RC3，而在欧洲筛查和临床队列中，A-ERSPC-RC3 的净获益更高。
A-ERSPC-RC3 可准确预测中国当代多中心临床队列的前列腺活检结果。CPCC-RC 可准确预测人群筛查队列中的前列腺癌，但在欧洲临床队列中预测能力欠佳。
