检测前列腺癌的风险计算器:系统审查
Frederique B Denijs1, Meike J van Harten2, Jonas J L Meenderink3
1Department of Urology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands. f.denijs@erasmusmc.nl.
Prostate cancer and prostatic diseases
|June 3, 2024
概括
本综述确定了96种用于早期前列腺癌 (PCa) 检测的风险计算器 (RCs). 虽然RCs有助于查,但许多RCs缺乏外部验证,这影响了它们的临床适用性.
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.
- 医疗信息学 医疗信息学
背景情况:
- 早期发现前列腺癌 (PCa) 面临诸如过度诊断和不必要的测试等挑战.
- 欧洲泌尿病学协会建议使用风险计算器 (RCs) 的风险适应方法.
- PRAISE-U项目旨在对早期PCa检测算法的临床RC进行概述.
研究的目的:
- 系统地审查和识别临床风险计算器 (RCs) 以预测临床显著的前列腺癌 (PCa) 在活检.
- 提供目前可用的RCs的概述,适用于早期PCa检测.
主要方法:
- 从2010年1月到2023年7月,使用多个数据库 (Medline ALL,Embase,Web of Science,Cochrane,Google Scholar) 进行了系统审查.
- 搜索术语包括"前列腺癌"",查/诊断"和"预测模型".
- 纳入标准侧重于系统性审查,元分析和临床试验,不包括预先准人群的研究,诊断PCa患者或小样本大小 (<50名男性).
主要成果:
- 从6474个已识别的物品中,包括了140个物品,从而产生了96个独特的RC.
- 45个RC接受了外部验证,其中28个在多个队伍中进行了验证.
- 验证的RCs包含临床因素 (17),临床因素+MRI (19),血液生物标志物 (4) 或尿路生物标志物 (5),其中AUC的中位数从0.63到0.93.
结论:
- 本综述分析了现有的RC,其利用和性能,证实了它们在缓解早期检测局限性的作用.
- RCs被整合到现代实践和查试验中,证明了提高PCa检测的能力.
- 许多RC缺乏外部验证是一个问题,需要仔细评估它们对特定人群的适用性.
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