PDF(Pubmed)
Abstract：
OBJECTIVE: To validate the Barcelona-magnetic resonance imaging predictive model (BCN-MRI PM) for clinically significant prostate cancer (csPCa) in Catalonia, a Spanish region with 7.9 million inhabitants. Additionally, the BCN-MRI PM is validated in men receiving 5-alpha reductase inhibitors (5-ARI).
METHODS: A population of 2,212 men with prostate-specific antigen serum level > 3.0 ng/ml and/or a suspicious digital rectal examination who underwent multiparametric MRI and targeted and/or systematic biopsies in the year 2022, at ten participant centers of the Catalonian csPCa early detection program, were selected. 120 individuals (5.7%) were identified as receiving 5-ARI treatment for longer than a year. The risk of csPCa was retrospectively assessed with the Barcelona-risk calculator 2 (BCN-RC 2). Men undergoing 5-ARI treatment for less than a year were excluded. CsPCa was defined when the grade group was ≥ 2.
RESULTS: The area under the curve of the BCN-MRI PM in 5-ARI naïve men was 0.824 (95% CI 0.783-0.842) and 0.849 (0.806-0.916) in those receiving 5-ARI treatment, p 0.475. Specificities at 100, 97.5, and 95% sensitivity thresholds were to 2.7, 29.3, and 39% in 5-ARI naïve men, while 43.5, 46.4, and 47.8%, respectively in 5-ARI users. The application of BCN-MRI PM would result in a reduction of 23.8% of prostate biopsies missing 5% of csPCa in 5-ARI naïve men, while reducing 25% of prostate biopsies without missing csPCa in 5-ARI users.
CONCLUSIONS: The BCN-MRI PM has achieved successful validation in Catalonia and, notably, for the first time, in men undergoing 5-ARI treatment.
METHODS: A population of 2,212 men with prostate-specific antigen serum level > 3.0 ng/ml and/or a suspicious digital rectal examination who underwent multiparametric MRI and targeted and/or systematic biopsies in the year 2022, at ten participant centers of the Catalonian csPCa early detection program, were selected. 120 individuals (5.7%) were identified as receiving 5-ARI treatment for longer than a year. The risk of csPCa was retrospectively assessed with the Barcelona-risk calculator 2 (BCN-RC 2). Men undergoing 5-ARI treatment for less than a year were excluded. CsPCa was defined when the grade group was ≥ 2.
RESULTS: The area under the curve of the BCN-MRI PM in 5-ARI naïve men was 0.824 (95% CI 0.783-0.842) and 0.849 (0.806-0.916) in those receiving 5-ARI treatment, p 0.475. Specificities at 100, 97.5, and 95% sensitivity thresholds were to 2.7, 29.3, and 39% in 5-ARI naïve men, while 43.5, 46.4, and 47.8%, respectively in 5-ARI users. The application of BCN-MRI PM would result in a reduction of 23.8% of prostate biopsies missing 5% of csPCa in 5-ARI naïve men, while reducing 25% of prostate biopsies without missing csPCa in 5-ARI users.
CONCLUSIONS: The BCN-MRI PM has achieved successful validation in Catalonia and, notably, for the first time, in men undergoing 5-ARI treatment.
摘要：
目的：验证巴塞罗那磁共振成像预测模型（BCN-MRIPM）对加泰罗尼亚有临床意义的前列腺癌（csPCa），有790万居民的西班牙地区。此外,BCN-MRIPM在接受5-α还原酶抑制剂(5-ARI)的男性中得到验证.
方法：2,212名前列腺特异性抗原血清水平>3.0ng/ml和/或可疑直肠指检者，在2022年接受了多参数MRI和靶向和/或系统活检，在加泰罗尼亚csPCa早期检测计划的十个参与者中心，被选中。120个人（5.7％）被确定为接受5-ARI治疗超过一年。使用巴塞罗那风险计算器2（BCN-RC2）回顾性评估csPCa的风险。接受5-ARI治疗少于一年的男性被排除在外。当等级组≥2时定义CsPCa。
结果：在接受5-ARI治疗的男性中，BCN-MRIPM曲线下面积为0.824（95％CI0.783-0.842）和0.849（0.806-0.916）。第0.475页。在5-ARI天真男性中，100、97.5和95％敏感性阈值的特异性分别为2.7、29.3和39％，而43.5、46.4和47.8％，分别在5-ARI用户中。BCN-MRIPM的应用将导致减少23.8％的前列腺活检缺失5％的csPCa在5-ARI天真的男性，在5-ARI使用者中减少25％的前列腺活检而不丢失csPCa。
结论：BCN-MRIPM已在加泰罗尼亚成功验证，特别是,第一次,在接受5-ARI治疗的男性中。
方法：2,212名前列腺特异性抗原血清水平>3.0ng/ml和/或可疑直肠指检者，在2022年接受了多参数MRI和靶向和/或系统活检，在加泰罗尼亚csPCa早期检测计划的十个参与者中心，被选中。120个人（5.7％）被确定为接受5-ARI治疗超过一年。使用巴塞罗那风险计算器2（BCN-RC2）回顾性评估csPCa的风险。接受5-ARI治疗少于一年的男性被排除在外。当等级组≥2时定义CsPCa。
结果：在接受5-ARI治疗的男性中，BCN-MRIPM曲线下面积为0.824（95％CI0.783-0.842）和0.849（0.806-0.916）。第0.475页。在5-ARI天真男性中，100、97.5和95％敏感性阈值的特异性分别为2.7、29.3和39％，而43.5、46.4和47.8％，分别在5-ARI用户中。BCN-MRIPM的应用将导致减少23.8％的前列腺活检缺失5％的csPCa在5-ARI天真的男性，在5-ARI使用者中减少25％的前列腺活检而不丢失csPCa。
结论：BCN-MRIPM已在加泰罗尼亚成功验证，特别是,第一次,在接受5-ARI治疗的男性中。
