A Multivariate Diagnostic Model Based on Urinary EpCAM-CD9-Positive Extracellular Vesicles for Prostate Cancer Diagnosis
| Autor: | Pan Yu, Xuchu Wang, Gong Zhang, Yibei Dai, Yiwen Sang, Ying Cao, Yiyun Wang, Zhihua Tao, Zhenping Liu, Lingyu Zhang, Danhua Wang, Ying Ping |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Oncology
History Multivariate statistics medicine.medical_specialty Cancer Research Polymers and Plastics Urinary system medicine.medical_treatment multivariate diagnostic model Disease urologic and male genital diseases Industrial and Manufacturing Engineering Prostate cancer Informed consent Internal medicine Diagnostic model medicine chemiluminescent immunoassay Business and International Management RC254-282 Original Research Prostatectomy business.industry Area under the curve Neoplasms. Tumors. Oncology. Including cancer and carcinogens Extracellular vesicle medicine.disease prostate cancer EpCAM extracellular vesicle business |
| Zdroj: | Frontiers in Oncology, Vol 11 (2021) Frontiers in Oncology |
| Popis: | IntroductionProstate cancer (PCa) is one of the most frequently diagnosed cancers and the leading cause of cancer death in males worldwide. Although prostate-specific antigen (PSA) screening has considerably improved the detection of PCa, it has also led to a dramatic increase in overdiagnosing indolent disease due to its low specificity. This study aimed to develop and validate a multivariate diagnostic model based on the urinary epithelial cell adhesion molecule (EpCAM)-CD9–positive extracellular vesicles (EVs) (uEVEpCAM-CD9) to improve the diagnosis of PCa.MethodsWe investigated the performance of uEVEpCAM-CD9 from urine samples of 193 participants (112 PCa patients, 55 benign prostatic hyperplasia patients, and 26 healthy donors) to diagnose PCa using our laboratory-developed chemiluminescent immunoassay. We applied machine learning to training sets and subsequently evaluated the multivariate diagnostic model based on uEVEpCAM-CD9 in validation sets.ResultsResults showed that uEVEpCAM-CD9 was able to distinguish PCa from controls, and a significant decrease of uEVEpCAM-CD9 was observed after prostatectomy. We further used a training set (N = 116) and constructed an exclusive multivariate diagnostic model based on uEVEpCAM-CD9, PSA, and other clinical parameters, which showed an enhanced diagnostic sensitivity and specificity and performed excellently to diagnose PCa [area under the curve (AUC) = 0.952, P < 0.0001]. When applied to a validation test (N = 77), the model achieved an AUC of 0.947 (P < 0.0001). Moreover, this diagnostic model also exhibited a superior diagnostic performance (AUC = 0.917, P < 0.0001) over PSA (AUC = 0.712, P = 0.0018) at the PSA gray zone.ConclusionsThe multivariate model based on uEVEpCAM-CD9 achieved a notable diagnostic performance to diagnose PCa. In the future, this model may potentially be used to better select patients for prostate transrectal ultrasound (TRUS) biopsy. |
| Databáze: | OpenAIRE |
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