Prognostic accuracy of Prostate Health Index and urinary Prostate Cancer Antigen 3 in predicting pathologic features after radical prostatectomy
Prognostic accuracy of Prostate Health Index and urinary Prostate Cancer Antigen 3 in predicting pathologic features after radical prostatectomy
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DOI：
10.1016/j.urolonc.2014.12.002
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发表时间：
2015-04-01
影响因子：
2.7
通讯作者：
Damiano, Rocco
中科院分区：
文献类型：
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作者：
Cantiello, Francesco;Russo, Giorgio Ivan;Damiano, Rocco
目的：比较前列腺健康指数（PHI）和前列腺癌抗原3在预测前列腺癌根治性前列腺切除术（RP）患者队列中病理特征的预后准确性（PCa.Methods and Materials）：我们评估了156例活检证实的临床局部PCa患者，他们在2013年1月至2013年12月期间在2家三级医疗机构接受RP。在首次前列腺活检前采集血液和尿液样本，用于[-2]前列腺特异性抗原（PSA）、其衍生物和PCA 3测量。进行单变量和多变量逻辑回归分析以确定潜在预测肿瘤体积>0.5 ml、病理学Gleason总和>= 7、病理学证实的显著PCa、囊外扩展和精囊浸润的变量。在多变量分析和1,000个重采样数据的自举后，包括PHI显著增加了基线多变量模型的准确性，该模型包括患者年龄、总PSA、游离PSA、阳性核心比率、临床分期、前列腺体积、体重指数和活检Gleason评分（GS），预测研究结果。特别是，为了预测肿瘤体积>0.5，将PHI添加到基线模型中显著提高了7.9%的预测准确性。（受试者工作特征曲线下面积[AUC] = 89.3 vs. 97.2，P > 0.05），而PCA 3没有导致显著增加，尽管PHI和PCA 3都显著提高了预测囊外扩张的准确性，与基线模型相比，达到独立预测状态（所有P < 0.01），仅PHI导致对精囊侵入的预测的显著改善（AUC = 92.2，P < 0.05，增益为3.6%）。对于这些结果，PCA 3并没有增加增量predictive value.Conclusions：在接受RP的患者队列中，PHI在预测更具侵略性和扩展PCa的存在的能力方面明显优于PCA 3。(C)2015 Elsevier Inc. All rights reserved.
Objective: To compare the prognostic accuracy of Prostate Health Index (PHI) and Prostate Cancer Antigen 3 in predicting pathologic features in a cohort of patients who underwent radical prostatectomy (RP) for prostate cancer (PCa).Methods and materials: We evaluated 156 patients with biopsy-proven, clinically localized PCa who underwent RP between January 2013 and December 2013 at 2 tertiary care institutions. Blood and urinary specimens were collected before initial prostate biopsy for [-2] pro-prostate-specific antigen (PSA), its derivates, and PCA3 measurements. Univariate and multivariate logistic regression analyses were carried out to determine the variables that were potentially predictive of tumor volume >0.5 ml, pathologic Gleason sum >= 7, pathologically confirmed significant PCa, extracapsular extension, and seminal vesicles invasions.Results: On multivariate analyses and after bootstrapping with 1,000 resampled data, the inclusion of PHI significantly increased the accuracy of a baseline multivariate model, which included patient age, total PSA, free PSA, rate of positive cores, clinical stage, prostate volume, body mass index, and biopsy Gleason score (GS), in predicting the study outcomes. Particularly, to predict tumor volume >0.5, the addition of PHI to the baseline model significantly increased predictive accuracy by 7.9% (area under the receiver operating characteristics curve [AUC] = 89.3 vs. 97.2, P > 0.05), whereas PCA3 did not lead to a significant increase.Although both PHI and PCA3 significantly improved predictive accuracy to predict extracapsular extension compared with the baseline model, achieving independent predictor status (all P's < 0.01), only PHI led to a significant improvement in the prediction of seminal vesicles invasions (AUC = 92.2, P < 0.05 with a gain of 3.6%).In the subset of patients with GS = 7. For these outcomes, PCA3 did not add incremental predictive value.Conclusions: In a cohort of patients who underwent RP, PHI is significantly better than PCA3 in the ability to predict the presence of both more aggressive and extended PCa. (C) 2015 Elsevier Inc. All rights reserved.