Valor de la densidad del antígeno prostático específico y de la densidad del antígeno prostático específico de la zona transicional en el diagnóstico del cáncer de próstata

The aim of this study was to develop nomograms for predicting prostate cancer and its zonal location using prostate-specific antigen density, prostate volume, and their zone-adjusted derivatives. A total of 928 consecutive patients with prostate-specific antigen (PSA) less than 20.0 ng/mL, who underwent transrectal ultrasound-guided transperineal 12-core prostate biopsy at West China Hospital between 2011 and 2014, were retrospectively enrolled. The patients were randomly split into training cohort (70%, n = 650) and validation cohort (30%, n = 278). Predicting models and the associated nomograms were built using the training cohort, while the validations of the models were conducted using the validation cohort. Univariate and multivariate logistic regression was performed. Then, new nomograms were generated based on multivariate regression coefficients. The discrimination power and calibration of these nomograms were validated using the area under the ROC curve (AUC) and the calibration curve. The potential clinical effects of these models were also tested using decision curve analysis. In total, 285 (30.7%) patients were diagnosed with prostate cancer. Among them, 131 (14.1%) and 269 (29.0%) had transition zone prostate cancer and peripheral zone prostate cancer. Each of zone-adjusted derivatives-based nomogram had an AUC more than 0.75. All nomograms had higher calibration and much better net benefit than the scenarios in predicting patients with or without different zones prostate cancer. Prostate-specific antigen density, prostate volume, and their zone-adjusted derivatives have important roles in detecting prostate cancer and its zonal location for patients with PSA 2.5-20.0 ng/mL. To the best of our knowledge, this is the first nomogram using these parameters to predict outcomes of 12-core prostate biopsy. These instruments can help clinicians to increase the accuracy of prostate cancer screening and to avoid unnecessary prostate biopsy.

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The role of targeted biopsy methods in the prostate cancer diagnosis

Petov

Сапелко

Danilov

et al. 2021

Onkourologiâ

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The current prostate cancer screening program results in unnecessary biopsies in a quarter of patients, overdiagnosis of clinically insignificant prostate cancer (ISUP 1) and overtreatment. Intoducing multiparametric magnetic resonance imaging into routine practice before biopsy allows to decrease the number of biopsies, thereby reducing the burden on clinicians and increasing the likelihood of detecting clinically significant forms of prostate cancer (ISUP >2). The objective of this literature review is to compare targeted biopsy techniques and to determine their current role in the prostate cancer diagnosis.

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Valor de la densidad del antígeno prostático específico y de la densidad del antígeno prostático específico de la zona transicional en el diagnóstico del cáncer de próstata

Abstract: We conclude that PSAD and PSADTZ are not excessively useful for adequately discriminating between patients with prostate cancer and those with non-malignant disease, particularly when digital rectal examination is normal.

Cited by 3 publications

References 32 publications

Evaluación del antígeno especifico prostático (PSA) ajustado al volumen de la zona transicional en la detección del cáncer de próstata

Evaluación del antígeno especifico prostático (PSA) ajustado al volumen de la zona transicional en la detección del cáncer de próstata

The roles of prostate‐specific antigen (PSA) density, prostate volume, and their zone‐adjusted derivatives in predicting prostate cancer in patients with PSA less than 20.0 ng/mL

The role of targeted biopsy methods in the prostate cancer diagnosis

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