Developing a diagnostic model for predicting prostate cancer: a retrospective study based on Chinese multicenter clinical data  

作　　者：Chang-Ming Wang Lei Yuan Xue-Han Liu Shu-Qiu Chen Hai-Feng Wang Qi-Fei Dong Bin Zhang Ming-Shuo Huang Zhi-Yong Zhang Jun Xiao Tao Tao 

机构地区：[1]Department of Urology,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,China [2]Department of Radiology,The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,China [3]Core Facility Center for Medical Sciences,The First Affiliated Hospital of USTc,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei 230001,China [4]Department of Urology,Affiliated Zhongda Hospital of Southeast University,Nanjing 210009,China [5]Department of Urology,Shanghai East Hospital,Tongji University School of Medicine,Shanghai 200120,China [6]Department of Urology,Shanghai Changhai Hospital,Second Military Medical University,Shanghai 200000,China [7]Department of Urology,Affiliated Anhui Provincial Hospital of Anhui Medical University,Hefei 230001,China

出　　处：《Asian Journal of Andrology》2024年第1期34-40,共7页亚洲男性学杂志（英文版）

基　　金：This study was supported by the Key Research and Development Program of Anhui Province(No.202204295107020003);the National Natural Science Foundation of Anhui Province(No.2108085MH293);the Distinguished Young Scholars Fund of Anhui Province(No.2022AH020078);the Key health Project of Anhui Province(AHWJ2022a037).

摘　　要：The overdiagnosis of prostate cancer(PCa)caused by nonspecific elevation serum prostate-specific antigen(PSA)and the overtreatment of indolent PCa have become a global problem that needs to be solved urgently.We aimed to construct a prediction model and provide a risk stratification system to reduce unnecessary biopsies.In this retrospective study,clinical data of 1807 patients from three Chinese hospitals were used.The final model was built using stepwise logistic regression analysis.The apparent performance of the model was assessed by receiver operating characteristic curves,calibration plots,and decision curve analysis.Finally,a risk stratification system of clinically significant prostate cancer(csPCa)was created,and diagnosis-free survival analyses were performed.Following multivariable screening and evaluation of the diagnostic performances,a final diagnostic model comprised of the PSA density and Prostate Imaging-Reporting and Data System(PI-RADS)score was established.Model validation in the development cohort and two external cohorts showed excellent discrimination and calibration.Finally,we created a risk stratification system using risk thresholds of 0.05 and 0.60 as the cut-off values.The follow-up results indicated that the diagnosis-free survival rate for csPCa at 12 months and 24 months postoperatively was 99.7%and 99.4%,respectively,for patients with a risk threshold below O.05 after the initial negative prostate biopsy,which was significantly better than patients with higher risk.Our diagnostic model and risk stratification system can achieve a personalized risk calculation of csPCa.It provides a standardized tool for Chinese patients and physicians when considering thenecessity of prostatebiopsy.

关 键 词：NOMOGRAM prostate biopsy prostate cancer Prostate Imaging-Reporting and Data System prostate-specific antigen density 

分 类 号：R737.25[医药卫生—肿瘤]