Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Auprich, M; Haese, A; Walz, J; Pummer, K; de la Taille, A; Graefen, M; de Reijke, T; Fisch, M; Kil, P; Gontero, P; Irani, J; Chun, FKH.
External Validation of Urinary PCA3-Based Nomograms to Individually Predict Prostate Biopsy Outcome.
EUR UROL. 2010; 58(5): 727-732.
Doi: 10.1016/j.eururo.2010.06.038
Web of Science
PubMed
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FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Auprich Marco
- Co-Autor*innen der Med Uni Graz
- Pummer Karl
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- Abstract:
- Background: Prior to safely adopting risk stratification tools, their performance must be tested in an external patient cohort. Objective: To assess accuracy and generalizability of previously reported, internally validated, prebiopsy prostate cancer antigen 3 (PCA3) gene-based nomograms when applied to a large, external, European cohort of men at risk of prostate cancer (PCa). Design, setting, and participants: Biopsy data, including urinary PCA3 score, were available for 621 men at risk of PCa who were participating in a European multi-institutional study. Intervention: All patients underwent a >= 10-core prostate biopsy. Biopsy indication was based on suspicious digital rectal examination, persistently elevated prostate-specific antigen level (2.5-10 ng/ml) and/or suspicious histology (atypical small acinar proliferation of the prostate, >/= two cores affected by high-grade prostatic intraepithelial neoplasia in first set of biopsies). Measurements: PCA3 scores were assessed using the Progensa assay (Gen-Probe Inc, San Diego, CA, USA). According to the previously reported nomograms, different PCA3 score codings were used. The probability of a positive biopsy was calculated using previously published logistic regression coefficients. Predicted outcomes were compared to the actual biopsy results. Accuracy was calculated using the area under the curve as a measure of discrimination; calibration was explored graphically. Results and limitations: Biopsy-confirmed PCa was detected in 255 (41.1%) men. Median PCA3 score of biopsy-negative versus biopsy-positive men was 20 versus 48 in the total cohort, 17 versus 47 at initial biopsy, and 37 versus 53 at repeat biopsy (all p <= 0.002). External validation of all four previously reported PCA3-based nomograms demonstrated equally high accuracy (0.73-0.75) and excellent calibration. The main limitations of the study reside in its early detection setting, referral scenario, and participation of only tertiary-care centers. Conclusions: In accordance with the original publication, previously developed PCA3-based nomograms achieved high accuracy and sufficient calibration. These novel nomograms represent robust tools and are thus generalizable to European men at risk of harboring PCa. Consequently, in presence of a PCA3 score, these nomograms may be safely used to assist clinicians when prostate biopsy is contemplated. (C) 2010 European Association of Urology. Published by Elsevier B.V. All rights reserved.
- Find related publications in this database (using NLM MeSH Indexing)
- Antigens, Neoplasm - urine
- Biopsy -
- Humans -
- Male -
- Nomograms -
- Predictive Value of Tests -
- Prostate - pathology
- Prostatic Intraepithelial Neoplasia - epidemiology
- Prostatic Neoplasms - epidemiology
- Reproducibility of Results -
- Risk Factors -
- Tumor Markers, Biological - urine
- Find related publications in this database (Keywords)
- Prostate biopsy
- Prostate cancer gene 3
- Biomarker
- Prostate cancer
- Nomogram
- External validation