Clinical Validation of MyProstateScore 2.0 Testing Using First-Catch, Non-Digital Rectal Examination Urine.

IF 5.9 2区 医学 Q1 UROLOGY & NEPHROLOGY
Jeffrey J Tosoian, Yuping Zhang, Jacob I Meyers, Spencer Heaton, Javed Siddiqui, Lanbo Xiao, Keavash D Assani, Daniel A Barocas, Ashley E Ross, Zoey Chopra, Grace C Herron, Jacob A Edelson, Nathan J Graham, Udit Singhal, Simpa S Salami, Todd M Morgan, Ganesh S Palapattu, John T Wei, Arul M Chinnaiyan
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引用次数: 0

Abstract

Purpose: The 18-gene MyProstateScore 2.0 (MPS2) test was previously validated for detection of grade group ≥ 2 (GG ≥ 2) prostate cancer using post-digital rectal examination (DRE) urine. To improve ease of testing, we validated MPS2 using first-catch, non-DRE urine.

Materials and methods: Patients provided first-catch urine before biopsy. MPS2 values were calculated using previously validated models differing only by extent of clinical data included biomarkers alone (BA; no clinical data), biomarkers and clinical factors (BA + CF), and biomarkers, clinical factors, and prostate volume (BA + CF + PV). The primary outcome was GG ≥ 2 cancer on biopsy. MPS2 performance and clinical consequences of testing were compared with PSA and the Prostate Cancer Prevention Trial risk calculator (PCPTrc).

Results: The cohort included 266 men with median PSA 6.6 ng/mL (IQR, 4.9-9.1) of whom 103 (39%) had GG ≥ 2 cancer on biopsy. The AUC for GG ≥ 2 cancer was 57% for PSA, 62% for PCPTrc, and 71%, 74%, and 77% for MPS2 models. Under a testing approach detecting > 90% of GG ≥ 2 cancers, MPS2 testing would have avoided 36% to 42% of unnecessary biopsies, as compared with 13% using the PCPTrc. In patients with a prior negative biopsy, MPS2 testing would have avoided 44% to 53% of repeat biopsies, as compared with only 2.6% using PCPTrc.

Conclusions: Using first-catch urine, MPS2 meaningfully improved the proportion of biopsies avoided relative to PCPTrc while maintaining highly sensitive detection of GG ≥ 2 cancer. Non-DRE testing provides a convenient, objective, and highly accurate testing option to reduce the need for imaging and biopsy in men with elevated PSA.

myprostatcore 2.0首次检测非dre尿液的临床验证
目的:18基因myprostatcore 2.0 (MPS2)检测先前通过直肠指检(DRE)后尿液检测≥2级(GG≥2)前列腺癌。为了提高测试的便利性,我们使用首次捕获的非dre尿液验证MPS2。材料和方法:患者在活检前先取尿液。MPS2值是使用先前验证的模型计算的,差异仅在于临床数据的程度,包括:生物标志物单独(BA;无临床数据)、生物标志物和临床因素(BA+CF)以及生物标志物、临床因素和前列腺体积(BA+CF+PV)。主要预后指标为活组织检查GG≥2癌。将MPS2的性能和临床结果与PSA和前列腺癌预防试验风险计算器(PCPTrc)进行比较。结果:该队列纳入266名男性,中位PSA为6.6 ng/mL (IQR为4.9-9.1),其中103名(39%)活检为GG≥2癌。GG≥2癌的曲线下面积PSA为57%,PCPTrc为62%,MPS2为71%,74%和77%。在一种检测90% GG≥2型癌症的检测方法下,MPS2检测将避免36% -42%的不必要的活检,而使用PCPTrc则为13%。在既往活检阴性的患者中,MPS2检测可避免44-53%的重复活检,而使用PCPTrc仅可避免2.6%的重复活检。结论:与PCPTrc相比,使用首捕尿液,MPS2显著提高了避免活检的比例,同时保持了对GG≥2癌的高灵敏度检测。非dre检测提供了一种方便、客观和高度准确的检测选择,以减少PSA升高的男性对成像和活检的需求。
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
Journal of Urology
Journal of Urology 医学-泌尿学与肾脏学
CiteScore
11.50
自引率
7.60%
发文量
3746
审稿时长
2-3 weeks
期刊介绍: The Official Journal of the American Urological Association (AUA), and the most widely read and highly cited journal in the field, The Journal of Urology® brings solid coverage of the clinically relevant content needed to stay at the forefront of the dynamic field of urology. This premier journal presents investigative studies on critical areas of research and practice, survey articles providing short condensations of the best and most important urology literature worldwide, and practice-oriented reports on significant clinical observations.
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