Abstract:
Clinical decisions based on the test results for prostate-specific antigen often result in overdiagnosis and overtreatment. Multiparametric magnetic resonance imaging (mpMRI) can be used to identify high-grade prostate cancer (HGPCa; Gleason score ≥3 + 4); however, certain limitations remain such as inter-reader variability and false negatives. The combination of mpMRI and prostate cancer (PCa) biomarkers (prostate-specific antigen density, Proclarix, TMPRSS2:ERG gene fusion, Michigan prostate score, ExoDX prostate intelliscore, four kallikrein score, select molecular diagnosis, prostate health index, and prostate health index density) demonstrates high accuracy in the diagnosis of HGPCa, ensuring that patients avoid unnecessary prostate biopsies with a low leakage rate. This manuscript describes the characteristics and diagnostic performance of each biomarker alone and in combination with mpMRI, with the intension to provide a basis for decision-making in the diagnosis and treatment of HGPCa. Additionally, we explored the applicability of the combination protocol to the Asian population.
摘要:
基于前列腺特异性抗原的测试结果的临床决策通常会导致过度诊断和过度治疗。多参数磁共振成像(mpMRI)可用于识别高级别前列腺癌(HGPCa;Gleason评分≥3+4);然而,某些限制仍然存在,如读者间的可变性和假阴性。mpMRI和前列腺癌(PCa)生物标志物的组合(前列腺特异性抗原密度,Proclalix,TMPRSS2:ERG基因融合,密歇根前列腺评分,ExoDX前列腺智能评分,四激肽释放酶得分,选择分子诊断,前列腺健康指数,和前列腺健康指数密度)在HGPCa的诊断中表现出很高的准确性,确保患者避免不必要的前列腺活检和低泄漏率。该手稿描述了每种生物标志物单独以及与mpMRI结合的特征和诊断性能,旨在为HGPCa的诊断和治疗提供决策依据。此外,我们探讨了联合方案对亚洲人群的适用性.