Establishing a model predicting Gleason grade group upgrading in prostate cancer.

IF 1.9 3区医学 Q4 ANDROLOGY

Translational andrology and urology Pub Date : 2024-08-31 Epub Date: 2024-08-22 DOI:10.21037/tau-24-155

Jian Chen, Qiming Chen, Ze Wang, Xuzhi Yan, Yapeng Wang, Yao Zhang, Jun Zhang, Jing Xu, Qiang Ma, Peng Zhong, Dianzheng Zhang, Qiuli Liu, Weihua Lan, Jun Jiang

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引用次数: 0

Abstract

Background: Gleason grade group (GG) upgrading is associated with increased biochemical recurrence (BCR), local progression, and decreased cancer-specific survival (CSS) in prostate cancer (PCa). However, descriptions of the risk factors of GG upgrading are scarce. The objective of this study was to identify risk factors and establish a model to predict GG upgrading.

Methods: There were 361 patients with PCa who underwent radical prostatectomy between May 2011 and February 2022 enrolled. Univariate and multivariate logistic regression analyses were identified and nomogram further narrowed down the contributing factors in GG upgrading. The correction curve and decision curve were used to assess the model.

Results: In the overall cohort, 141 patients had GG upgrading. But the subgroup cohort (GG ≤2) showed that 68 patients had GG upgrading. Multivariate logistic regression analysis showed that in the overall cohort, total prostate-specific antigen (tPSA) ≥10 ng/mL, systemic immune-inflammation index (SII) >379.50, neutrophil-lymphocyte ratio (NLR) >2.13, the GG of biopsy ≥3, the number of positive cores >3 were independent risk factors in GG upgrading. In the cohort of biopsy GG ≤2, multivariate logistic regression showed that the tPSA ≥10 ng/mL, SII >379.50 and the number of positive cores >3 were independent risk factors in GG upgrading. A novel model predicting GG upgrading was established based on these three parameters. The area under the curve (AUC) of the prediction model was 0.759. The C-index of the nomogram was 0.768. The calibration curves of the model showed good predictive performance. Clinical decision curves indicated clinical benefit in the interval of 20% to 90% of threshold probability and good clinical utility.

Conclusions: Combined levels of tPSA, SII and the positive biopsy cores distinguish patients with high-risk GG upgrading in the group of biopsy GG ≤2 and are helpful in the decision of treatment plans.

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建立预测前列腺癌格里森分级组升级的模型。

背景：格里森等级组（GG）升级与前列腺癌（PCa）的生化复发（BCR）增加、局部进展和癌症特异性生存率（CSS）降低有关。然而，有关 GG 升高风险因素的描述却很少。本研究的目的是确定风险因素，并建立预测GG升级的模型：2011年5月至2022年2月期间，361名PCa患者接受了根治性前列腺切除术。确定了单变量和多变量逻辑回归分析，并通过提名图进一步缩小了GG升级的诱因范围。校正曲线和决策曲线用于评估模型：结果：在总体队列中，141 名患者出现 GG 升级。但在亚组队列（GG ≤2）中，有 68 名患者出现 GG 升级。多变量逻辑回归分析显示，在总体队列中，总前列腺特异性抗原（tPSA）≥10 ng/mL、全身免疫炎症指数（SII）>379.50、中性粒细胞-淋巴细胞比值（NLR）>2.13、活检GG≥3、阳性核芯数量>3是GG升级的独立危险因素。在活检 GG ≤2 的队列中，多变量逻辑回归显示，tPSA ≥10 纳克/毫升、SII >379.50 和阳性核芯数量 >3 是 GG 升级的独立危险因素。根据这三个参数建立了一个预测 GG 升级的新模型。预测模型的曲线下面积（AUC）为 0.759。提名图的 C 指数为 0.768。模型的校准曲线显示出良好的预测性能。临床决策曲线显示，临床获益在阈值概率的 20% 至 90% 之间，临床效用良好：结论：tPSA、SII和阳性活检核心的综合水平可区分活检GG≤2组的高危GG升级患者，有助于治疗方案的决策。

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来源期刊

Translational andrology and urology Medicine-Urology

CiteScore

4.10

自引率

5.00%

发文量

期刊介绍： ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.