The role of prostate-specific antigen density and negative multiparametric magnetic resonance imaging in excluding prostate cancer for biopsy-naïve men: clinical outcomes from a high-volume center in China
This study aimed to assess the role of prostate-specific antigen density (PSAD) and negative multiparametric magnetic resonance imaging (mpMRI) in predicting prostate cancer for biopsy-naïve men based on a large cohort of the Chinese population. From a prostate biopsy database between March 2017 and...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Asian Journal of Andrology |
| Subjects: | |
| Online Access: | http://www.ajandrology.com/article.asp?issn=1008-682X;year=2022;volume=24;issue=6;spage=615;epage=619;aulast=Zhang |
| _version_ | 1811180259293265920 |
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| author | Chi-Chen Zhang Xiang Tu Tian-Hai Lin Di-Ming Cai Ling Yang Ling Nie Shi Qiu Zhen-Hua Liu Kun Jin Jia-Kun Li Xing-Yu Xiong Lu Yang Qiang Wei |
| author_facet | Chi-Chen Zhang Xiang Tu Tian-Hai Lin Di-Ming Cai Ling Yang Ling Nie Shi Qiu Zhen-Hua Liu Kun Jin Jia-Kun Li Xing-Yu Xiong Lu Yang Qiang Wei |
| author_sort | Chi-Chen Zhang |
| collection | DOAJ |
| description | This study aimed to assess the role of prostate-specific antigen density (PSAD) and negative multiparametric magnetic resonance imaging (mpMRI) in predicting prostate cancer for biopsy-naïve men based on a large cohort of the Chinese population. From a prostate biopsy database between March 2017 and July 2021, we retrospectively identified 240 biopsy-naïve patients with negative prebiopsy mpMRI (Prostate Imaging Reporting and Data System version 2 [PI-RADS v2] score <3). Logistic regression analysis was performed to select the potential predictors for clinically significant prostate cancer (csPCa). Receiver operating characteristic (ROC) curve analysis and area under the ROC curve (AUC) were performed to assess the diagnostic accuracy. The negative predictive values of mpMRI in excluding any cancer and csPCa were 83.8% (201/240) and 90.8% (218/240), respectively. ROC curve analysis indicated that PSAD was the most promising predictor, with an AUC value of 0.786 (95% confidence interval [CI]: 0.699–0.874), and multiparametric logistic regression analysis confirmed that higher PSAD remained a significant marker for predicting csPCa (odds ratio [OR]: 10.99, 95% CI: 2.75–44.02, P < 0.001). Combining negative mpMRI and PSAD below 0.20 ng ml−2 obviously increased the predictive value in excluding PCa (91.0%, 101/111) or csPCa (100.0%, 111/111). If a PSAD below 0.20 ng ml−2 was set as the criterion to omit biopsy, nearly 46.3% of patients (463 per 1000) with negative mpMRI could safely avoid unnecessary biopsy, with approximately 4.2% of patients (42 per 1000) at risk of missed diagnosis of PCa and no patients with csPCa missed. A PI-RADS v2 score <3 and a PSAD <0.20 ng ml−2 could be potential criteria for the Chinese population to omit prompt biopsy safely. |
| first_indexed | 2024-04-11T06:47:24Z |
| format | Article |
| id | doaj.art-c51913b05f6843efaddb454520e95c01 |
| institution | Directory Open Access Journal |
| issn | 1008-682X 1745-7262 |
| language | English |
| last_indexed | 2024-04-11T06:47:24Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Asian Journal of Andrology |
| spelling | doaj.art-c51913b05f6843efaddb454520e95c012022-12-22T04:39:19ZengWolters Kluwer Medknow PublicationsAsian Journal of Andrology1008-682X1745-72622022-01-0124661561910.4103/aja202220The role of prostate-specific antigen density and negative multiparametric magnetic resonance imaging in excluding prostate cancer for biopsy-naïve men: clinical outcomes from a high-volume center in ChinaChi-Chen ZhangXiang TuTian-Hai LinDi-Ming CaiLing YangLing NieShi QiuZhen-Hua LiuKun JinJia-Kun LiXing-Yu XiongLu YangQiang WeiThis study aimed to assess the role of prostate-specific antigen density (PSAD) and negative multiparametric magnetic resonance imaging (mpMRI) in predicting prostate cancer for biopsy-naïve men based on a large cohort of the Chinese population. From a prostate biopsy database between March 2017 and July 2021, we retrospectively identified 240 biopsy-naïve patients with negative prebiopsy mpMRI (Prostate Imaging Reporting and Data System version 2 [PI-RADS v2] score <3). Logistic regression analysis was performed to select the potential predictors for clinically significant prostate cancer (csPCa). Receiver operating characteristic (ROC) curve analysis and area under the ROC curve (AUC) were performed to assess the diagnostic accuracy. The negative predictive values of mpMRI in excluding any cancer and csPCa were 83.8% (201/240) and 90.8% (218/240), respectively. ROC curve analysis indicated that PSAD was the most promising predictor, with an AUC value of 0.786 (95% confidence interval [CI]: 0.699–0.874), and multiparametric logistic regression analysis confirmed that higher PSAD remained a significant marker for predicting csPCa (odds ratio [OR]: 10.99, 95% CI: 2.75–44.02, P < 0.001). Combining negative mpMRI and PSAD below 0.20 ng ml−2 obviously increased the predictive value in excluding PCa (91.0%, 101/111) or csPCa (100.0%, 111/111). If a PSAD below 0.20 ng ml−2 was set as the criterion to omit biopsy, nearly 46.3% of patients (463 per 1000) with negative mpMRI could safely avoid unnecessary biopsy, with approximately 4.2% of patients (42 per 1000) at risk of missed diagnosis of PCa and no patients with csPCa missed. A PI-RADS v2 score <3 and a PSAD <0.20 ng ml−2 could be potential criteria for the Chinese population to omit prompt biopsy safely.http://www.ajandrology.com/article.asp?issn=1008-682X;year=2022;volume=24;issue=6;spage=615;epage=619;aulast=Zhangbiopsy; magnetic resonance imaging; predictive value; prostate cancer; prostate-specific antigen density; transrectal ultrasound |
| spellingShingle | Chi-Chen Zhang Xiang Tu Tian-Hai Lin Di-Ming Cai Ling Yang Ling Nie Shi Qiu Zhen-Hua Liu Kun Jin Jia-Kun Li Xing-Yu Xiong Lu Yang Qiang Wei The role of prostate-specific antigen density and negative multiparametric magnetic resonance imaging in excluding prostate cancer for biopsy-naïve men: clinical outcomes from a high-volume center in China Asian Journal of Andrology biopsy; magnetic resonance imaging; predictive value; prostate cancer; prostate-specific antigen density; transrectal ultrasound |
| title | The role of prostate-specific antigen density and negative multiparametric magnetic resonance imaging in excluding prostate cancer for biopsy-naïve men: clinical outcomes from a high-volume center in China |
| title_full | The role of prostate-specific antigen density and negative multiparametric magnetic resonance imaging in excluding prostate cancer for biopsy-naïve men: clinical outcomes from a high-volume center in China |
| title_fullStr | The role of prostate-specific antigen density and negative multiparametric magnetic resonance imaging in excluding prostate cancer for biopsy-naïve men: clinical outcomes from a high-volume center in China |
| title_full_unstemmed | The role of prostate-specific antigen density and negative multiparametric magnetic resonance imaging in excluding prostate cancer for biopsy-naïve men: clinical outcomes from a high-volume center in China |
| title_short | The role of prostate-specific antigen density and negative multiparametric magnetic resonance imaging in excluding prostate cancer for biopsy-naïve men: clinical outcomes from a high-volume center in China |
| title_sort | role of prostate specific antigen density and negative multiparametric magnetic resonance imaging in excluding prostate cancer for biopsy naive men clinical outcomes from a high volume center in china |
| topic | biopsy; magnetic resonance imaging; predictive value; prostate cancer; prostate-specific antigen density; transrectal ultrasound |
| url | http://www.ajandrology.com/article.asp?issn=1008-682X;year=2022;volume=24;issue=6;spage=615;epage=619;aulast=Zhang |
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