The value of clinical and biparametric MRI nomogram in diagnosing extraprostatic ex-tension of prostate cancer
10.12354/j.issn.1000-8179.2024.20240817
- VernacularTitle:临床-双参数MRI列线图诊断前列腺癌包膜外侵犯的价值
- Author:
Zhang HU
1
;
Tao LINGSONG
;
Dai MIN
;
Zhu XIANFENG
;
Guo YONG
;
Xu GUANGXING
;
Zhang XIAOJIN
Author Information
1. 芜湖市第二人民医院医学影像科(安徽省芜湖市 241000)
- Keywords:
prostate cancer(PCa);
magnetic resonance imaging(MRI);
extraprostatic extension(EPE)
- From:
Chinese Journal of Clinical Oncology
2024;51(14):722-727
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of clinical and biparametric magnetic resonance imaging(bpMRI)in diagnosing extraprostatic ex-tension(EPE)of prostate cancer(PCa).Methods:This retrospective study assigned 107 patients into EPE(n=42)and organ-limited(n=65)groups based on their postoperative pathology after radical prostatectomy from August 2018 to May 2024 at Wuhu Second People's Hospit-al.The differences in the following clinical risk indicators were compared between the groups:age,total prostate specific antigen(tPSA),pro-state volume,prostate specific antigen density(PSAD)and International Society of Urological Pathology(ISUP)score for prostate puncture.The differences in MRI indicators,prostate imaging reporting and data system(PI-RADS)score and bpMRI were also identified.Binary Logist-ic regression analysis was used to construct clinical and joint models for diagnosing EPE,and screening independent influencing factors.The ROC curve analyze the independent influencing factors and diagnostic performance of the models.The DeLong test was used to compare the differences between the AUC models.A nomogram was draw,and performance evaluated.Results:The differences in tPSA,PSAD,ISUP score for prostate puncture,PI-RADS score,and bpMRI were statistically significant between the two groups(P<0.05).The clinical model AUC was 0.821;while the AUCs of the combined model and independent influencing factors PSAD(OR=25.992),ISUP score for prostate puncture(OR=1.676),and bpMRI(OR=10.729)were 0.899,0.813,0.770,and 0.793 respectively(P<0.001).The combined model was superior to the clinical model(Z=2.502 and P=0.012).The average AUC for 5-fold cross-validation was 0.887,with high model calibration and a threshold range of 5%-85%,indicating clinical benefits.Conclusions:The combined model nomogram derived from clinical and bpMRI indicators is highiy valuable for diagnosing PCa EPE.
