Abstract
Purpose
To evaluate and compare the efficacy of prostate volume (PV), transitional zone volume (TZV), and prostate volume index (PVI, the ratio of TZV to peripheral zone volume) in the identification of men at risk of prostate cancer (PCa) and high-progression PCa (HPPCa) at the initial biopsy (IBX) in a real-world population.
Methods
From Jul 2014 to Aug 2016, data on 1144 patients who had undergone the initial prostate biopsies were prospectively collected and analyzed. Univariate and multivariate logistic regression analyses were performed to identify the independent predictors for PCa and HPPCa. Based on independent predictors, nomogram models were developed and internally validated to assess a man’s risk of harboring PCa and HPPCa.
Results
The detection rates of PCa and HPPCa were 43.09% (493/1144) and 39.16% (448/1144), respectively. In the multivariate analyses, age, PSA, TZV, DRE, and TRUS instead of PV or PVI were independent predictors for PCa and HPPCa, percent free PSA was independent predictor for PCa not for HPPCa. Such independent predictors were finally included in the nomogram models. The AUCs of TZV-based nomogram models were 87.0% for PCa and 87.7% for HPPCa, which were higher than that of PSA alone or other predictive models.
Conclusions
TZV is a better predictive biomarker than PV or PVI for PCa and HPPCa, we recommend adding TZV but not PV or PVI to the nomogram models to improve the predictive accuracy of PCa and HPPCa at IBX.
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Acknowledgements
This study was supported by the National Natural Science Foundation of China (81572536, 81672850), Science and Technology Commission of Shanghai Municipality (14140901700, 16411969800), the Joint Research Foundation for Innovative Medical Technology of Shanghai Shenkang Hospital Development Center (SHDC12015125), Shanghai Municipal Education Commission (15ZZ058), Shanghai Municipal Commission of Health and Family Planning (201640247), Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support (20152215), Key Disciplines Group Construction Project of Pudong Health Bureau of Shanghai (PWZxq2014-05), the Shanghai Jiao Tong University School of Medicine Translational Research Innovation Fund (15ZH4002), and Incubating Program for clinical Research and Innovation of Renji Hospital Shanghai Jiao Tong University School of Medicine (PYZY16-008, PYXJS16-015).
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This study was approved by the Ethics Committee at the Renji Hospital, Shanghai Jiao Tong University School of Medicine. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Y. Wang and S. Xie contributed equally to the manuscript.
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Wang, Y., Xie, S., Shangguan, X. et al. Prostate transitional zone volume-based nomogram for predicting prostate cancer and high progression prostate cancer in a real-world population. J Cancer Res Clin Oncol 143, 1157–1166 (2017). https://doi.org/10.1007/s00432-017-2389-3
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DOI: https://doi.org/10.1007/s00432-017-2389-3