Falagario Ugo Giovanni, Busetto Gian Maria, Netti Giuseppe Stefano, Sanguedolce Francesca, Selvaggio Oscar, Infante Barbara, Ranieri Elena, Stallone Giovanni, Carrieri Giuseppe, Cormio Luigi
Department of Urology and Organ Transplantation, University of Foggia, 71122 Foggia, Italy.
Clinical Pathology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy.
Cancers (Basel). 2021 Mar 31;13(7):1611. doi: 10.3390/cancers13071611.
To test and internally validate serum Pentraxin-3 (PTX3) levels as a potential PCa biomarker to predict prostate biopsy (PBx) results.
Serum PSA and serum PTX3 were prospectively assessed in patients scheduled for PBx at our Institution due to increased serum PSA levels or abnormal digital rectal examination. Uni- and multivariable logistic regression analysis, area under the receiver operating characteristic curve (AUC), and decision curve analysis (DCA), were used to test the accuracy of serum PTX3 in predicting anyPCa and clinically significant PCa (csPCa) defined as Gleason Grade (GG) ≥ 2.
Among the 455 eligible patients, PCa was detected in 49% and csPCa in 25%. During univariate analysis, PTX3 outperformed other variables in predicting both anyPCa and csPCa. The addition of PTX3 to multivariable models based on standard clinical variables, significantly increased each model's predictive accuracy for anyPCa (AUC from 0.73 to 0.82; < 0.001) and csPCa (AUC from 0.79 to 0.83; < 0.001). At DCA, PTX3, and PTX3, density showed higher net benefit than PSA and PSA density and increased the net benefit of multivariable models in deciding when to perform PBx.
Serum PTX3 levels might be of clinical utility in predicting prostate biopsy results. Should our findings be confirmed, this novel reflex test could be used to reduce the number and burden of unnecessary prostate biopsies.
检测并内部验证血清五聚素3（PTX3）水平作为预测前列腺穿刺活检（PBx）结果的潜在前列腺癌（PCa）生物标志物。
对因血清前列腺特异性抗原（PSA）水平升高或直肠指检异常而计划在本机构进行PBx的患者，前瞻性评估血清PSA和血清PTX3。采用单变量和多变量逻辑回归分析、受试者操作特征曲线下面积（AUC）以及决策曲线分析（DCA），以检验血清PTX3预测任何PCa以及定义为Gleason分级（GG）≥2的临床显著PCa（csPCa） 的准确性。
在455例符合条件的患者中，49%检测出PCa，25%检测出csPCa。单变量分析期间，PTX3在预测任何PCa和csPCa方面均优于其他变量。将PTX3添加到基于标准临床变量的多变量模型中，显著提高了每个模型对任何PCa（AUC从0.73提高到0.82；P<0.001）和csPCa（AUC从0.79提高到0.83；P<0.001）的预测准确性。在DCA中，PTX3和PTX3密度显示出比PSA和PSA密度更高的净效益，并增加了多变量模型在决定何时进行PBx时的净效益。
血清PTX3水平在预测前列腺穿刺活检结果方面可能具有临床应用价值。如果我们的研究结果得到证实，这种新型的反射试验可用于减少不必要的前列腺穿刺活检的数量和负担。
