The addition of interleukin-6 soluble receptor and transforming growth factor beta, improves a preoperative nomogram for predicting biochemical progression in patients with clinically localized prostate cancer
The addition of interleukin-6 soluble receptor and transforming growth factor beta, improves a preoperative nomogram for predicting biochemical progression in patients with clinically localized prostate cancer
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DOI：
10.1200/jco.2003.12.037
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发表时间：
2003-10-01
影响因子：
45.3
通讯作者：
Slawin, KM
中科院分区：
文献类型：
--
作者：
Kattan, MW;Shariat, SF;Slawin, KM
目的：已经开发了几种术前前列腺癌列线图，使用治疗前前列腺特异性抗原（PSA）水平、临床分期和活检Gleason分级预测进展风险。我们描述了一个新的诺模图的发展和性能。列线图为反映前列腺癌生物学行为的标准临床预测因子增加了新的标志物：治疗前血浆白细胞介素-6可溶性受体（IL 6SR）和转化生长因子β（1）水平（TGF-β（1））。患者和方法：在1994年11月7日至1997年12月22日期间，714名cT 1c至cT 3a期前列腺癌患者在卫理公会医院接受了根治性前列腺切除术治疗，德克萨斯州休斯顿在术前储存的血浆中测量IL 6SR和TGF-β（1）的血浆水平。根据这些数据，开发了一个列线图来预测手术后5年内PSA进展的概率。用自举法验证诺模图，以评估其分辨力和校准性能。在多变量考克斯模型中，PSA（P = .004），IL6SR（P <0.001），TGF-β（1）（P < .001），原发性Gleason分级（P < .002）和次要Gleason分级（P = .029）与PSA进展相关，而临床分期（P = .696）与PSA进展无关。诺模图似乎校准良好，受试者工作特征曲线（即一致性指数）下的自举校正面积为0.83。作为比较，省略IL 6SR和TGF-β（1）的列线图的一致性指数仅为0.75。结论：我们发现治疗前血浆IL 6SR和TGF-β（1）水平显著提高了预测生化进展的能力。已开发并内部验证了列线图，包括这些分子标志物的治疗前水平以及标准临床标志物的沿着。(C)2003年，美国临床肿瘤学会。
Purpose: Several preoperative prostate cancer nomograms have been developed that predict risk of progression using pretreatment prostate-specific antigen (PSA) level, clinical stage, and biopsy Gleason grade. We describe the development and performance of a new nomogram. The nomogram adds new markers to the standard clinical predictors that reflect the biologic behavior of prostate cancer: pretreatment plasma levels of interleukin-6 soluble receptor (IL6SR) and transforming growth factor beta(1) (TGF-beta(1)).Patients and Methods: Between November 7,1994 and December 22, 1997, 714 patients with stage cT1c to cT3a prostate cancer and no prior therapy were treated with radical prostatectomy at the Methodist Hospital, Houston TX. Plasma levels of IL6SR and TGF-beta(1), were measured in banked preoperative plasma. With these data, a nomogram was developed to predict the probability of PSA progression within 5 years of surgery. The nomogram was validated with bootstrapping to assess its discrimination and calibration performance.Results: In the multivariable Cox model, PSA (P = .004), IL6SR (P < .001), TGF-beta(1) (P < .001), primary Gleason grade (P < .002), and secondary Gleason grade (P = .029) were associated with PSA progression, whereas clinical stage (P = .696) was not. The nomogram seemed to be well calibrated and had a bootstrap-corrected area under the receiver operating characteristic curve (ie, concordance index) of 0.83. For comparison, a nomogram that omitted IL6SR and TGF-beta(1) achieved a concordance index of only 0.75.Conclusion: We found that pretreatment plasma levels of IL6SR and TGF-beta(1) improved the ability to predict biochemical progression by a prognostically substantial margin. A nomogram including the pretreatment levels of these molecular markers, along with standard clinical markers, has been developed and internally validated. (C) 2003 by American Society of Clinical Oncology.