Development and validation of a clinical nomogram to predict prostatic inflammation in men with lower urinary tract symptoms.

IF 5.1 2区医学 Q1 ONCOLOGY

Prostate Cancer and Prostatic Diseases Pub Date : 2024-07-06 DOI:10.1038/s41391-024-00857-5

Stavros Gravas, Cosimo De Nunzio, Luís Campos Pinheiro, Javier Ponce de León, Konstantinos Skriapas, Ziad Milad, Riccardo Lombardo, Mariana Medeiros, Pantelis Makrides, Michael Samarinas, Mauro Gacci

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Abstract

Background: Prostatic inflammation is an important etiological component of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). The Prostatic Inflammation Nomogram Study (PINS) aimed to develop and validate a nomogram for predicting the presence of prostatic inflammation in men with LUTS.

Methods: This non-interventional, cross-sectional, prospective study was conducted in six secondary/tertiary centers across Cyprus, Greece, Italy, Portugal, and Spain. Men (≥40 years) with BPH/LUTS scheduled to undergo prostatic surgery or transrectal ultrasound-guided (TRUS) prostate biopsy were included. Fifteen demographic and clinical participant characteristics were selected as possible predictors of prostatic inflammation. The presence of inflammation (according to Irani score) in the prostatic tissue samples obtained from surgery/TRUS biopsy was determined. The effect of each characteristic on the likelihood a prostate specimen demonstrated inflammation (classified by Irani score into two categories, 0-2 [no/minimal inflammation] or 3-6 [moderate/severe inflammation]) was assessed using multiple logistic regression. A nomogram was developed and its discriminatory ability and validity were assessed.

Results: In total, 423 patients (mean age 68.9 years) were recruited. Prostate volume ultrasound (PVUS) > 50 mL, history of urinary tract infection (UTI) treatment, presence of diabetes, and International Prostate Symptom Score (IPPS) Storage score were statistically significant predictors of Irani classification. Logistic regression demonstrated a statistically significant effect for leucocytes detected via urine dipstick, presence of diabetes, PVUS > 50 mL, history of UTIs, and higher IPSS Storage score for the odds of an inflammatory score category of 3-6 versus 0-2. The nomogram had a concordance index of 0.71, and good internal validity.

Conclusions: The nomogram developed from PINS had good predictive ability and identified various characteristics to be predictors of prostatic inflammation. Use of the nomogram may aid in individualizing treatment for LUTS, by identifying individuals who are candidates for therapies targeting prostatic inflammation.

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开发并验证用于预测下尿路症状男性前列腺炎症的临床提名图。

背景：前列腺炎症是良性前列腺增生症（BPH）和下尿路症状（LUTS）的重要病因。前列腺炎症提名图研究（PINS）旨在开发和验证一种提名图，用于预测患有下尿路症状的男性是否存在前列腺炎症：这项非干预性、横断面、前瞻性研究在塞浦路斯、希腊、意大利、葡萄牙和西班牙的六个二级/三级中心进行。研究对象包括计划接受前列腺手术或经直肠超声引导（TRUS）前列腺活检的良性前列腺增生症/前列腺痛（BPH/LUTS）男性患者（≥40 岁）。研究人员选择了 15 个人口统计学和临床参与者特征作为前列腺炎症的可能预测因素。确定了手术/TRUS 活检获得的前列腺组织样本中是否存在炎症（根据伊尼评分）。使用多重逻辑回归评估了每个特征对前列腺标本显示炎症（按伊尼评分分为 0-2 [无/轻度炎症] 或 3-6 [中度/重度炎症] 两类）的可能性的影响。结果：共招募了 423 名患者（平均年龄 68.9 岁）。前列腺体积超声（PVUS）> 50 mL、尿路感染（UTI）治疗史、糖尿病和国际前列腺症状评分（IPPS）存储评分对 Irani 分级有显著的统计学预测作用。逻辑回归结果表明，通过尿液浸量计检测到的白细胞、糖尿病、PVUS > 50 mL、UTI 治疗史和较高的 IPSS 存储评分对炎症评分类别为 3-6 和 0-2 的几率具有统计学意义。该提名图的一致性指数为 0.71，具有良好的内部有效性：根据 PINS 开发的提名图具有良好的预测能力，并确定了可预测前列腺炎症的各种特征。使用该提名图可以帮助对前列腺痛进行个体化治疗，确定哪些人适合采用针对前列腺炎症的疗法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prostate Cancer and Prostatic Diseases 医学-泌尿学与肾脏学

CiteScore

10.00

自引率

6.20%

发文量

142

审稿时长

6-12 weeks

期刊介绍： Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management. Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis. Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.