Department of Urology and Organ Transplantation, University of Foggia, 71122 Foggia, Italy.
Department of Radiology, University of Foggia, 71122 Foggia, Italy.
Int J Mol Sci. 2023 Jan 26;24(3):2449. doi: 10.3390/ijms24032449.
Risk calculator (RC) combining PSA with other clinical information can help to better select patients at risk of prostate cancer (PCa) for prostate biopsy. The present study aimed to develop a new Pca RC, including MRI and bladder outlet obstruction parameters (BOOP). The ability of these parameters in predicting PCa and clinically significant PCa (csPCa: ISUP GG ≥ 2) was assessed by binary logistic regression. A total of 728 patients were included from two institutions. Of these, 395 (54.3%) had negative biopsies and 161 (22.11%) and 172 (23.6%) had a diagnosis of ISUP GG1 PCa and csPCa. The two RC ultimately included age, PSA, DRE, prostate volume (pVol), post-voided residual urinary volume (PVR), and PIRADS score. Regarding BOOP, higher prostate volumes (csPCa: OR 0.98, CI 0.97,0.99) and PVR ≥ 50 mL (csPCa: OR 0.27, CI 0.15, 0.47) were protective factors for the diagnosis of any PCa and csPCa. AUCs after internal validation were 0.78 (0.75, 0.82) and 0.82 (0.79, 0.86), respectively. Finally, decision curves analysis demonstrated higher benefit compared to the first-generation calculator and MRI alone. These novel RC based on MRI and BOOP may help to better select patient for prostate biopsy after prostate MRI.
风险计算器 (RC) 结合 PSA 与其他临床信息可以帮助更好地选择前列腺癌 (PCa) 风险患者进行前列腺活检。本研究旨在开发一种新的 Pca RC，包括 MRI 和膀胱出口梗阻参数 (BOOP)。通过二项逻辑回归评估这些参数预测 PCa 和临床显著 PCa (csPCa：ISUP GG ≥ 2) 的能力。本研究共纳入了来自两个机构的 728 名患者。其中 395 名 (54.3%) 活检结果为阴性，161 名 (22.11%) 和 172 名 (23.6%) 诊断为 ISUP GG1 PCa 和 csPCa。最终的两个 RC 包括年龄、PSA、DRE、前列腺体积 (pVol)、排尿后残余尿量 (PVR) 和 PIRADS 评分。关于 BOOP，较高的前列腺体积 (csPCa：OR 0.98，CI 0.97，0.99) 和 PVR ≥ 50 mL (csPCa：OR 0.27，CI 0.15，0.47) 是诊断任何 PCa 和 csPCa 的保护因素。内部验证后的 AUC 分别为 0.78 (0.75，0.82) 和 0.82 (0.79，0.86)。最后，决策曲线分析表明与第一代计算器和 MRI 单独相比，具有更高的获益。这些基于 MRI 和 BOOP 的新型 RC 可能有助于更好地选择前列腺 MRI 后进行前列腺活检的患者。
