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非侵入性生物标记测试和MRI的实用性,以预测前列腺癌的诊断
Mark I Sultan1, Linda M Huynh1, Sarah Kamil1
1Department of Urology, University of California, Irvine, Orange, CA, USA.
International urology and nephrology
|September 24, 2023
概括
OPKO4K评分和ExoDx IntelliScore有效预测前列腺癌,它们与MRI一起的联合使用显著提高了活检确认病例的诊断准确性.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 生物标志物发现发现
背景情况:
- 提升的前列腺特异性抗原 (PSA) 水平需要准确的方法来检测前列腺癌.
- 区分惰性和攻击性前列腺癌对于适当的患者管理至关重要.
- 需要新的生物标志物来提高 PSA 升高的男性前列腺癌的诊断准确度.
研究的目的:
- 评估ExoDx IntelliScore和OPKO4K得分在预测前列腺癌中的诊断性能.
- 评估这些生物标志物的实用性,作为独立的预测因素,并与临床和MRI数据相结合.
- 确定这些生物标志物对活检确认的前列腺癌的综合预测能力.
主要方法:
- 以后回顾的PSA升高的患者接受OPKO4K和/或EXODxIntelliScore测试和MRI.
- 开发了四种回归模型,其中包括临床因素 (年龄,PSA,DRE),OPKO4K得分,ExoDx IntelliScore和MRI PIRADS分类.
- 接收器运行特征 (ROC) 曲线的生成以评估每个模型的曲线下的面积 (AUC).
主要成果:
- OPKO4K评分显示灵敏度为86.7%和NPV为72.3%; ExoDx IntelliScore显示灵敏度为76.5%和NPV为77.1%.
- 仅仅临床标志物就产生了0.559.55的AUC.
- 临床标记物OPKO4K,Exodx IntelliScore和MRI的组合达到0.825的高AUC,这表明预测性能优越.
结论:
- 无论是OPKO4K评分还是ExoDx IntelliScore都独立表现出高负预测值.
- OPKO4K评分,ExoDx IntelliScore和MRI的组合显著提高了前列腺癌的预测能力.
- 这些生物标志物,特别是结合起来,为改善前列腺癌诊断和潜在地减少不必要的活检提供了有希望的工具.
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