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      Development of a novel nomogram for predicting clinically significant prostate cancer with the prostate health index and multiparametric MRI

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          Abstract

          Introduction

          On prostate biopsy, multiparametric magnetic resonance imaging (mpMRI) and the Prostate Health Index (PHI) have allowed prediction of clinically significant prostate cancer (csPCa).

          Methods

          To predict the likelihood of csPCa, we created a nomogram based on a multivariate model that included PHI and mpMRI. We assessed 315 males who were scheduled for prostate biopsies.

          Results

          We used the Prostate Imaging Reporting and Data System version 2 (PI-RADS V2) to assess mpMRI and optimize PHI testing prior to biopsy. Univariate analysis showed that csPCa may be identified by PHI with a cut-off value of 77.77, PHID with 2.36, and PI-RADS with 3 as the best threshold. Multivariable logistic models for predicting csPCa were developed using PI-RADS, free PSA (fPSA), PHI, and prostate volume. A multivariate model that included PI-RADS, fPSA, PHI, and prostate volume had the best accuracy (AUC: 0.882). Decision curve analysis (DCA), which was carried out to verify the nomogram’s clinical applicability, showed an ideal advantage (13.35% higher than the model that include PI-RADS only).

          Discussion

          In conclusion, the nomogram based on PHI and mpMRI is a valuable tool for predicting csPCa while avoiding unnecessary biopsy as much as possible.

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          Most cited references40

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Comparing the Areas under Two or More Correlated Receiver Operating Characteristic Curves: A Nonparametric Approach

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              MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis

              Multiparametric magnetic resonance imaging (MRI), with or without targeted biopsy, is an alternative to standard transrectal ultrasonography-guided biopsy for prostate-cancer detection in men with a raised prostate-specific antigen level who have not undergone biopsy. However, comparative evidence is limited.
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                Author and article information

                Contributors
                Journal
                Front Oncol
                Front Oncol
                Front. Oncol.
                Frontiers in Oncology
                Frontiers Media S.A.
                2234-943X
                29 November 2022
                2022
                : 12
                : 1068893
                Affiliations
                [1] 1Department of Urology, Taizhou Hospital of Zhejiang Province affiliated with Wenzhou Medical University, Linhai , Taizhou, Zhejiang, China
                [2] 2Department of Pathology, Taizhou Hospital of Zhejiang Province affiliated with Wenzhou Medical University, Linhai , Taizhou, Zhejiang, China
                [3] 3Department of Urology, Taizhou Cancer Hospital, Wenling , Taizhou, Zhejiang, China
                [4] 4Department of Radiation Oncology Center, Taizhou Cancer Hospital, Wenling , Taizhou, Zhejiang, China
                [5] 5Department of Radiation Oncology Center, Huashan Hospital, Shanghai Medical College, Fudan University , Shanghai, China
                [6] 6Department of Traditional Chinese Medicine, Taizhou Hospital of Zhejiang Province affiliated with Wenzhou Medical University, Linhai , Taizhou, Zhejiang, China
                Author notes

                Edited by: Angelo Naselli, MultiMedica Holding SpA (IRCCS), Italy

                Reviewed by: Daniele Castellani, Polytechnic University of Le Marche, Italy; Octavian Sabin Tataru, Sciences and Technology of Târgu Mures, Romania

                *Correspondence: Jia-Jia Wang, wangjj6604@ 123456enzemed.com ; Lin Zheng, y215180575@ 123456zju.edu.cn ; Zhi-Rui Zhou, zzr3711@ 123456163.com

                This article was submitted to Genitourinary Oncology, a section of the journal Frontiers in Oncology

                Article
                10.3389/fonc.2022.1068893
                9745809
                36523980
                148b74b6-2827-485b-a0bd-cf84bd2b23dd
                Copyright © 2022 Mo, Zhang, Zheng, Huang, Zheng, Zhou and Wang

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 13 October 2022
                : 11 November 2022
                Page count
                Figures: 5, Tables: 3, Equations: 0, References: 40, Pages: 9, Words: 4532
                Categories
                Oncology
                Original Research

                Oncology & Radiotherapy
                prostate cancer,nomogram,multiparametric magnetic resonance imaging (mpmri),prostate health index,predicting

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