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在黑人男性中开发和验证前列腺活检风险计算器

Neil A Mistry¹, Zequn Sun², Jamila Sweis¹

¹Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

The Journal of urology

|November 2, 2023

概括

针对黑人男性开发的新型前列腺活检风险计算器在检测显著前列腺癌 (PCa) 时,与现有的工具相比,显示出更好的准确性. 这种量身定制的方法可以提高活检决策和患者的结果.

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.
生物统计学生物统计学

背景情况:

前列腺癌 (PCa) 风险分层对于活检决定至关重要.
现有的风险计算器在不同人群中可能没有最佳的性能,特别是黑人男性的PCa风险更高.
需要开发特定于种族的工具来提高诊断准确度.

研究的目的:

开发和验证一款针对黑人男性的新型前列腺活检风险计算器.
为了比较新计算器的性能与已建立的工具,如前列腺癌预防试验版本2.0.0.
为了评估发现格里森等级组 (GG) ≥2前列腺癌 (PCa) 的检测.

主要方法:

有望招募两组接受前列腺活检的黑人男性.
使用后勤回归的三种风险预测模型的开发,包括PSA,数字直肠检查 (DRE) 和前列腺体积等变量.
在特定风险值下使用C统计,校准曲线和净收益曲线验证模型.

主要成果:

开发了三种模型 (神秘太阳1,2和3),C统计数据范围从0.74到0.78.
开发的模型表现出与现有计算器相当或更高的性能.
在10%和30%的风险值下,新模型尽量减少不必要的活检,同时适当地识别GG≥2PCa.

结论:

为黑人男性量身定制的风险计算器可以提高临床上显著的前列腺癌的检测.
这种方法可能会改善活检决策和改善患者的治疗结果.
种族特异性风险分层对于公平有效的前列腺癌护理至关重要.

关键词:

不同的差异,不平等的差异.前列腺活检活检前列腺活检前列腺癌是前列腺癌.风险计算器风险计算器风险预测风险预测

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