To analyze the performance of the Prostate Health Index(phi)and its derivatives for predicting Gleason score(GS)upgrading between prostate biopsy and radical prostatectomy(RP)in the Chinese population,an observational...To analyze the performance of the Prostate Health Index(phi)and its derivatives for predicting Gleason score(GS)upgrading between prostate biopsy and radical prostatectomy(RP)in the Chinese population,an observational,prospective RP cohort consisting of 351 patients from two medical centers was established from January 2017 to September 2020.Pathological reclassification was determined by the Gleason Grade Group(GG).The area under the receiver operating characteristic curve(AUC)and logistic regression(LR)models were used to evaluate the predictive performance of predictors.In clinically low-risk patients with biopsy GG≤2,phi(odds ratio[OR]=1.80,95%confidence interval[95%CI]:1.14-2.82,P=0.01)and its derivative phi density(PHID;OR=2.34,95%CI:1.30-4.20,P=0.005)were significantly associated with upgrading to GG≥3 after RP,and the results were confirmed by multivariable analysis.Similar results were observed in patients with biopsy GG of 1 for the prediction of upgrading to RP GG≥2.Compared to the base model(AUC=0.59),addition of the phi or PHID could provide additional predictive value for GS upgrading in low-risk patients(AUC=0.69 and 0.71,respectively,both P<0.05).In conclusion,phi and PHID could predict GS upgrading after RP in clinically low-risk patients.展开更多
Eastern Cooperative Oncology Group(ECOG)performance status and Gleason score are commonly investigated factors for overall survival(OS)in men with castration-resistant prostate cancer(CRPC).However,there is a lack of ...Eastern Cooperative Oncology Group(ECOG)performance status and Gleason score are commonly investigated factors for overall survival(OS)in men with castration-resistant prostate cancer(CRPC).However,there is a lack of consistency regarding their prognostic or predictive value for OS.Therefore,we performed this meta-analysis to assess the associations of ECOG performance status and Gleason score with OS in CRPC patients and compare the two markers in patients under different treatment regimens or with different chemotherapy histories.A systematic literature review of monotherapy studies in CRPC patients was conducted in the PubMed database until May 2019.The data from 8247 patients in 34 studies,including clinical trials and real-world data,were included in our meta-analysis.Of these,twenty studies reported multivariate results and were included in our main analysis.CRPC patients with higher ECOG performance statuses(≥2)had a significantly increased mortality risk than those with lower ECOG performance statuses(<2),hazard ratio(HR):2.10,95%confidence interval(CI):1.68-2.62,and P<0.001.The synthesized HR of OS stratified by Gleason score was 1.01,with a 95%CI of 0.62-1.67(Gleason score≥8 vs<8).Subgroup analysis showed that there was no significant difference in pooled HRs for patients administered taxane chemotherapy(docetaxel and cabazitaxel)and androgen-targeting therapy(abiraterone acetate and enzalutamide)or for patients with different chemotherapy histories.ECOG performance status was identified as a significant prognostic factor in CRPC patients,while Gleason score showed a weak prognostic value for OS based on the available data in our meta-analysis.展开更多
背景与目的:前列腺癌穿刺标本的Gleason评分是术前进行预后判断及制定治疗方案的重要参考之一,其准确性直接影响对预后的评价及具体治疗措施的选择。本研究主要探讨前列腺癌穿刺标本与根治标本Gleason评分的差异,分析影响穿刺标本Gleaso...背景与目的:前列腺癌穿刺标本的Gleason评分是术前进行预后判断及制定治疗方案的重要参考之一,其准确性直接影响对预后的评价及具体治疗措施的选择。本研究主要探讨前列腺癌穿刺标本与根治标本Gleason评分的差异,分析影响穿刺标本Gleason评分准确性的可能因素。方法:收集穿刺活检证实为前列腺癌并接受根治术的前列腺癌患者126例,采用新Gleason分级评分标准对穿刺和根治标本进行重新评分,并采用Kappa一致性检验及配对卡方检验,对两者的Gleason评分进行比较,对可能影响两者符合率的因素进行二分类Logistic回归分析。结果:126例患者中穿刺标本的Gleason评分与根治标本71例(56.3%)一致,17例(13.5%)偏高,38例(30.2%)偏低,差异具有统计学意义(P<0.05)。将两者评分划分为不同的预后组,差异仍具有统计学意义(P<0.05)。偏差与年龄、术前前列腺特异抗原(prostate specific antigen,PSA)水平、前列腺体积、临床分期及每针最大癌累及无显著相关性(P>0.05),而与穿刺阳性针数百分比显著相关(OR=2.482,P<0.05)。结论:穿刺标本与根治标本的Gleason评分一致性一般,多数情况穿刺标本评分偏低,少数评分偏高;穿刺的阳性针数百分比是影响评分准确性的可能因素。展开更多
基金supported by grants from the National Natural Science Foundation of China(No.81772741 and No.81972645),Shanghai Jiao Tong University School of Medicine Gaofeng-Clinical Medicine Grant Support(No.20181701)Shanghai Municipal Human Resources and Social Security Bureau(No.2018052)to RNthe Clinical Research Project of Shanghai Health Commission(No.20214Y0511)to YSW.
文摘To analyze the performance of the Prostate Health Index(phi)and its derivatives for predicting Gleason score(GS)upgrading between prostate biopsy and radical prostatectomy(RP)in the Chinese population,an observational,prospective RP cohort consisting of 351 patients from two medical centers was established from January 2017 to September 2020.Pathological reclassification was determined by the Gleason Grade Group(GG).The area under the receiver operating characteristic curve(AUC)and logistic regression(LR)models were used to evaluate the predictive performance of predictors.In clinically low-risk patients with biopsy GG≤2,phi(odds ratio[OR]=1.80,95%confidence interval[95%CI]:1.14-2.82,P=0.01)and its derivative phi density(PHID;OR=2.34,95%CI:1.30-4.20,P=0.005)were significantly associated with upgrading to GG≥3 after RP,and the results were confirmed by multivariable analysis.Similar results were observed in patients with biopsy GG of 1 for the prediction of upgrading to RP GG≥2.Compared to the base model(AUC=0.59),addition of the phi or PHID could provide additional predictive value for GS upgrading in low-risk patients(AUC=0.69 and 0.71,respectively,both P<0.05).In conclusion,phi and PHID could predict GS upgrading after RP in clinically low-risk patients.
文摘Eastern Cooperative Oncology Group(ECOG)performance status and Gleason score are commonly investigated factors for overall survival(OS)in men with castration-resistant prostate cancer(CRPC).However,there is a lack of consistency regarding their prognostic or predictive value for OS.Therefore,we performed this meta-analysis to assess the associations of ECOG performance status and Gleason score with OS in CRPC patients and compare the two markers in patients under different treatment regimens or with different chemotherapy histories.A systematic literature review of monotherapy studies in CRPC patients was conducted in the PubMed database until May 2019.The data from 8247 patients in 34 studies,including clinical trials and real-world data,were included in our meta-analysis.Of these,twenty studies reported multivariate results and were included in our main analysis.CRPC patients with higher ECOG performance statuses(≥2)had a significantly increased mortality risk than those with lower ECOG performance statuses(<2),hazard ratio(HR):2.10,95%confidence interval(CI):1.68-2.62,and P<0.001.The synthesized HR of OS stratified by Gleason score was 1.01,with a 95%CI of 0.62-1.67(Gleason score≥8 vs<8).Subgroup analysis showed that there was no significant difference in pooled HRs for patients administered taxane chemotherapy(docetaxel and cabazitaxel)and androgen-targeting therapy(abiraterone acetate and enzalutamide)or for patients with different chemotherapy histories.ECOG performance status was identified as a significant prognostic factor in CRPC patients,while Gleason score showed a weak prognostic value for OS based on the available data in our meta-analysis.
文摘背景与目的:前列腺癌穿刺标本的Gleason评分是术前进行预后判断及制定治疗方案的重要参考之一,其准确性直接影响对预后的评价及具体治疗措施的选择。本研究主要探讨前列腺癌穿刺标本与根治标本Gleason评分的差异,分析影响穿刺标本Gleason评分准确性的可能因素。方法:收集穿刺活检证实为前列腺癌并接受根治术的前列腺癌患者126例,采用新Gleason分级评分标准对穿刺和根治标本进行重新评分,并采用Kappa一致性检验及配对卡方检验,对两者的Gleason评分进行比较,对可能影响两者符合率的因素进行二分类Logistic回归分析。结果:126例患者中穿刺标本的Gleason评分与根治标本71例(56.3%)一致,17例(13.5%)偏高,38例(30.2%)偏低,差异具有统计学意义(P<0.05)。将两者评分划分为不同的预后组,差异仍具有统计学意义(P<0.05)。偏差与年龄、术前前列腺特异抗原(prostate specific antigen,PSA)水平、前列腺体积、临床分期及每针最大癌累及无显著相关性(P>0.05),而与穿刺阳性针数百分比显著相关(OR=2.482,P<0.05)。结论:穿刺标本与根治标本的Gleason评分一致性一般,多数情况穿刺标本评分偏低,少数评分偏高;穿刺的阳性针数百分比是影响评分准确性的可能因素。
