Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen, Krankenhausstrasse 12, 91054 Erlangen, Germany.
Department of Urology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Fetscherstrasse 74, 01307 Dresden, Germany.
Cells. 2021 May 25;10(6):1315. doi: 10.3390/cells10061315.
Multiparametric MRI (mpMRI) and targeted biopsy of the prostate enhance the tumor detection rate. However, the prediction of clinically significant prostate cancer (PCa) is still limited. Our study tested the additional value of serum levels of selected miRNAs in combination with clinical and mpMRI information for PCa prediction and classification. A total of 289 patients underwent targeted mpMRI-ultrasound fusion-guided prostate biopsy complemented by systematic biopsy. Serum miRNA levels of miRNAs (miR-141, miR-375, miR-21-5p, miR-320b, miR-210-3p, let-7c, and miR-486) were determined by quantitative PCR. Detection of any PCa and of significant PCa were the outcome variables. The patient age, pre-biopsy PSA level, previous biopsy procedure, PI-RADS score, and serum miRNA levels were covariates for regularized binary logistic regression models. The addition of miRNA expression of miR-486 and let-7c to the baseline model, containing only clinical parameters, increased the predictive accuracy. Particularly in patients with PI-RADS ≤3, we determined a sensitivity for detecting significant PCa (Gleason score ≥ 7a corresponding to Grade group ≥2) of 95.2%, and an NPV for absence of significant PCa of 97.1%. This accuracy could be useful to support patient counseling in selected cases.
多参数 MRI（mpMRI）和前列腺靶向活检提高了肿瘤检出率。然而，临床上对前列腺癌（PCa）的预测仍然有限。本研究测试了联合临床和 mpMRI 信息的血清中选定 miRNA 水平对 PCa 预测和分类的附加价值。共有 289 名患者接受了靶向 mpMRI-超声融合引导下前列腺活检，同时进行了系统活检。通过定量 PCR 测定了 miRNA（miR-141、miR-375、miR-21-5p、miR-320b、miR-210-3p、let-7c 和 miR-486）的血清 miRNA 水平。检测任何 PCa 和显著 PCa 是结局变量。患者年龄、活检前 PSA 水平、既往活检程序、PI-RADS 评分和血清 miRNA 水平是正则化二项逻辑回归模型的协变量。将 miR-486 和 let-7c 的 miRNA 表达添加到仅包含临床参数的基线模型中，提高了预测准确性。特别是在 PI-RADS≤3 的患者中，我们确定了检测显著 PCa（Gleason 评分≥7a 对应等级组≥2）的敏感性为 95.2%，检测无显著 PCa 的阴性预测值为 97.1%。这种准确性可能有助于在选定的情况下为患者咨询提供支持。
