000046942 001__ 46942
000046942 005__ 20170504085637.0
000046942 0247_ $$2doi$$a10.1186/s12885-015-1623-0
000046942 0248_ $$2sideral$$a92069
000046942 037__ $$aART-2015-92069
000046942 041__ $$aeng
000046942 100__ $$aRubio-Briones, J.
000046942 245__ $$aOptimizing the clinical utility of PCA3 to diagnose prostate cancer in initial prostate biopsy
000046942 260__ $$c2015
000046942 5060_ $$aAccess copy available to the general public$$fUnrestricted
000046942 5203_ $$aBackground: PCA3 has been included in a nomogram outperforming previous clinical models for the prediction of any prostate cancer (PCa) and high grade PCa (HGPCa) at the initial prostate biopsy (IBx). Our objective is to validate such IBx-specific PCA3-based nomogram. We also aim to optimize the use of this nomogram in clinical practice through the definition of risk groups.
Methods: Independent external validation. Clinical and biopsy data from a contemporary cohort of 401 men with the same inclusion criteria to those used to build up the reference’s nomogram in IBx. The predictive value of the nomogram was assessed by means of calibration curves and discrimination ability through the area under the curve (AUC). Clinical utility of the nomogram was analyzed by choosing thresholds points that minimize the overlapping between probability density functions (PDF) in PCa and no PCa and HGPCa and no HGPCa groups, and net benefit was assessed by decision curves.
Results: We detect 28 % of PCa and 11 % of HGPCa in IBx, contrasting to the 46 and 20 % at the reference series. Due to this, there is an overestimation of the nomogram probabilities shown in the calibration curve for PCa. The AUC values are 0.736 for PCa (C.I.95 %:0.68–0.79) and 0.786 for HGPCa (C.I.95 %:0.71–0.87) showing an adequate discrimination ability. PDF show differences in the distributions of nomogram probabilities in PCa and not PCa patient groups. A minimization of the overlapping between these curves confirms the threshold probability of harboring PCa >30 % proposed by Hansen is useful to indicate a IBx, but a cut-off > 40 % could be better in series of opportunistic screening like ours. Similar results appear in HGPCa analysis. The decision curve also shows a net benefit of 6.31 % for the threshold probability of 40 %.
Conclusions: PCA3 is an useful tool to select patients for IBx. Patients with a calculated probability of having PCa over 40 % should be counseled to undergo an IBx if opportunistic screening is required.
000046942 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000046942 590__ $$a3.265$$b2015
000046942 591__ $$aONCOLOGY$$b85 / 213 = 0.399$$c2015$$dQ2$$eT2
000046942 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000046942 700__ $$0(orcid)0000-0003-0178-4567$$aBorque, A.$$uUniversidad de Zaragoza
000046942 700__ $$0(orcid)0000-0002-3007-302X$$aEsteban, L.M.
000046942 700__ $$aCasanova, J.
000046942 700__ $$aFernandez-Serra, A.
000046942 700__ $$aRubio, L.
000046942 700__ $$aCasanova-Salas, I.
000046942 700__ $$0(orcid)0000-0002-6474-2252$$aSanz, G.$$uUniversidad de Zaragoza
000046942 700__ $$aDomínguez-Escrig, J.
000046942 700__ $$aCollado, A.
000046942 700__ $$aGómez-Ferrer, A.
000046942 700__ $$aIborra, I.
000046942 700__ $$aRamírez-Backhaus, M.
000046942 700__ $$aMartínez, F.
000046942 700__ $$aCalatrava, A.
000046942 700__ $$aLopez-Guerrero, J.
000046942 7102_ $$11004$$2817$$aUniversidad de Zaragoza$$bDepartamento de Cirugía, Ginecología y Obstetricia$$cUrología
000046942 7102_ $$12007$$2265$$aUniversidad de Zaragoza$$bDepartamento de Métodos Estadísticos$$cEstadística e Investigación Operativa
000046942 773__ $$g15, 1 (2015), 633 [8 pp]$$pBMC CANCER$$tBMC CANCER$$x1471-2407
000046942 8564_ $$s1656882$$uhttp://zaguan.unizar.es/record/46942/files/texto_completo.pdf$$yVersión publicada
000046942 8564_ $$s101238$$uhttp://zaguan.unizar.es/record/46942/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000046942 909CO $$ooai:zaguan.unizar.es:46942$$particulos$$pdriver
000046942 951__ $$a2017-05-04-08:51:34
000046942 980__ $$aARTICLE