Evaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy.

Autor: Rajwa P; Department of Urology, Medical University of Silesia, 41-800 Zabrze, Poland.; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria., Huebner NA; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.; Working Group for Diagnostic Imaging in Urology (ABDU), Austrian Association of Urology (ÖGU), 1090 Vienna, Austria., Hostermann DI; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria., Grossmann NC; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.; Department of Urology, Luzerner Kantonsspital, 6000 Lucerne, Switzerland.; Department of Urology, University Hospital Zurich, 8091 Zurich, Switzerland., Schuettfort VM; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.; Department of Urology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany., Korn S; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria., Quhal F; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.; Department of Urology, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia., König F; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.; Department of Urology, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany., Mostafaei H; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.; Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz 51666-15731, Iran., Laukhtina E; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.; Institute for Urology and Reproductive Health, Sechenov University, 19435 Moscow, Russia., Mori K; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.; Department of Urology, The Jikei University School of Medicine, Tokyo 105-8461, Japan., Motlagh RS; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.; Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran 19857-17443, Iran., Yanagisawa T; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.; Department of Urology, The Jikei University School of Medicine, Tokyo 105-8461, Japan., Aydh A; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.; Department of Urology, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia., Bryniarski P; Department of Urology, Medical University of Silesia, 41-800 Zabrze, Poland., Pradere B; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria., Paradysz A; Department of Urology, Medical University of Silesia, 41-800 Zabrze, Poland., Baltzer PA; Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria., Grubmüller B; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria., Shariat SF; Department of Urology, Medical University of Vienna, 1090 Vienna, Austria.; Institute for Urology and Reproductive Health, Sechenov University, 19435 Moscow, Russia.; Karl Landsteiner Institute of Urology and Andrology, 1010 Vienna, Austria.; Department of Urology, Weill Cornell Medical College, New York, NY 10065, USA.; Department of Urology, University of Texas Southwestern, Dallas, TX 75390, USA.; Department of Urology, Second Faculty of Medicine, Charles University, 150 06 Prague, Czech Republic.; Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman 11942, Jordan.
Jazyk: angličtina
Zdroj: Journal of personalized medicine [J Pers Med] 2021 Nov 19; Vol. 11 (11). Date of Electronic Publication: 2021 Nov 19.
DOI: 10.3390/jpm11111231
Abstrakt: The aim of this study was to assess the predictive value of pre-biopsy blood-based markers in patients undergoing a fusion biopsy for suspicious prostate magnetic resonance imaging (MRI). We identified 365 consecutive patients who underwent MRI-targeted and systematic prostate biopsy for an MRI scored Prostate Imaging-Reporting and Data System Version (PI-RADS) ≥ 3. We evaluated the neutrophil/lymphocyte ratio (NLR), derived neutrophil/lymphocyte ratio (dNLR), platelet/lymphocyte ratio (PLR), systemic immune inflammation index (SII), lymphocyte/monocyte ratio (LMR,) de Ritis ratio, modified Glasgow Prognostic Score (mGPS), and prognostic nutrition index (PNI). Uni- and multivariable logistic models were used to analyze the association of the biomarkers with biopsy findings. The clinical benefits of biomarkers implemented in clinical decision-making were assessed using decision curve analysis (DCA). In total, 69% and 58% of patients were diagnosed with any prostate cancer and Gleason Grade (GG) ≥ 2, respectively. On multivariable analysis, only high dNLR (odds ratio (OR) 2.61, 95% confidence interval (CI) 1.23-5.56, p = 0.02) and low PNI (OR 0.48, 95% CI 0.26-0.88, p = 0.02) remained independent predictors for GG ≥ 2. The logistic regression models with biomarkers reached AUCs of 0.824-0.849 for GG ≥ 2. The addition of dNLR and PNI did not enhance the net benefit of a standard clinical model. Finally, we created the nomogram that may help guide biopsy avoidance in patients with suspicious MRI. In patients with PI-RADS ≥ 3 lesions undergoing MRI-targeted and systematic biopsy, a high dNLR and low PNI were associated with unfavorable biopsy outcomes. Pre-biopsy blood-based biomarkers did not, however, significantly improve the discriminatory power and failed to add a clinical benefit beyond standard clinical factors.
Databáze: MEDLINE
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