Falagario Ugo Giovanni, Silecchia Giovanni, Bruno Salvatore Mariano, Di Nauta Michele, Auciello Mario, Sanguedolce Francesca, Milillo Paola, Macarini Luca, Selvaggio Oscar, Carrieri Giuseppe, Cormio Luigi
Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy.
Department of Urology, Bonomo Teaching Hospital, Andria, Italy.
Front Oncol. 2021 Jan 8;10:603384. doi: 10.3389/fonc.2020.603384. eCollection 2020.
European Association of Urology (EAU) guidelines recommend using risk-calculators (RCs), imaging or additional biomarkers in asymptomatic men at risk of prostate cancer (PCa).
To compare the performance of mpMRI, a RC we recently developed and two commonly used RC not including mpMRI in predicting the risk of PCa, as well as the added value of mpMRI to each RC.
Single-center retrospective study evaluating 221 biopsy-naïve patients who underwent prebiopsy mpMRI.
Patients' probabilities of any PCa and clinically significant PCa (csPC, defined as Gleason-Score ≥3 + 4) were computed according to mpMRI, European Randomized Study of Screening for Prostate Cancer RC (ERSPC-RC), the Prostate Biopsy Collaborative Group RC (PBCG-RC) and the Foggia Prostate Cancer RC (FPC-RC). Logistic regression, AUC, and Decision curve analysis (DCA) were used to assess the accuracy of tested models.
The FPC-RC outperformed mpMRI in diagnosing both any PCa (AUC 0.76 0.69) and csPCa (AUC 0.80 0.75). Conversely mpMRI showed a higher accuracy in predicting any PCa compared to the PBCG-RC and the ERSPC-RC but similar performances in predicting csPCa. At multivariable analysis predicting csPCa and any PCa, the addition of mpMRI findings improved the accuracy of each calculator. DCA showed that the FPC-RC provided a greater net benefit than mpMRI and the other RCs. The addition of mpMRI findings improved the net benefit provided by each calculator.
mpMRI was outperformed by the novel FPC-RC and showed similar performances compared to the PBCG and ERSPC RCs in predicting csPCa. The addition of mpMRI findings improved the diagnostic accuracy of each of these calculators.
欧洲泌尿外科学会（EAU）指南建议，对于有前列腺癌（PCa）风险的无症状男性，使用风险计算器（RCs）、影像学检查或其他生物标志物。
比较多参数磁共振成像（mpMRI）、我们最近开发的一种RC以及两种不包括mpMRI的常用RC在预测PCa风险方面的性能，以及mpMRI对每种RC的附加值。
设计、设置和参与者：单中心回顾性研究，评估221例未接受过活检且在活检前接受了mpMRI检查的患者。
根据mpMRI、欧洲前列腺癌筛查随机研究RC（ERSPC-RC）、前列腺活检协作组RC（PBCG-RC）和福贾前列腺癌RC（FPC-RC）计算患者患任何PCa和临床显著PCa（csPC，定义为Gleason评分≥3 + 4）的概率。采用逻辑回归、AUC和决策曲线分析（DCA）来评估测试模型的准确性。
在诊断任何PCa（AUC 0.76对0.69）和csPCa（AUC 0.80对0.75）方面，FPC-RC的表现优于mpMRI。相反，与PBCG-RC和ERSPC-RC相比，mpMRI在预测任何PCa方面显示出更高的准确性，但在预测csPCa方面表现相似。在多变量分析预测csPCa和任何PCa时，添加mpMRI结果提高了每个计算器的准确性。DCA显示，FPC-RC比mpMRI和其他RCs提供了更大的净效益。添加mpMRI结果提高了每个计算器提供的净效益。
新型FPC-RC的表现优于mpMRI，在预测csPCa方面与PBCG和ERSPC RCs表现相似。添加mpMRI结果提高了这些计算器中每一个的诊断准确性。
