PCA3联合TMPRSS2-ERG融合基因检测提高前列腺穿刺结果预测精度

目的构建高预测精度前列腺穿刺结果预测模型。方法前瞻性搜集100例PSA小于20ng/mL行前列腺穿刺活检术的患者资料,病例信息包括年龄、直肠指诊结果、PSA、游离PSA百分比、前列腺体积、直肠超声异常结果、PCA3、TMPRSS2-ERG融合基因、CTAGE5-KHDRBS3融合基因、USP9Y-TTTY15融合基因等,单因素和多因素logistic回归分析并构建回归模型及nomogram,应用ROC分析其预测精度。结果年龄、PSA、前列腺体积、PCA3及TMPRSS2-ERG融合基因为前列腺癌独立风险因子,构建基于上述5个指标的预测模型,AUC值为0.897。结论PCA3联合TMPRSS2-ERG融合基因能提高前列腺穿刺结果预测模型精度。

Prostate cancer antigen 3 combined with TMPRSS2 ERG gene fusion can improve the predictive accuracy of prostate biopsy results

Objective  To develop a predictive model for prostate biopsy outcome with high accuracy. Methods   Informations including age, digital rectum examnation result (DRE), prostate specific antigen (PSA), percent free PSA,prostate volume, transrectum ultrasound findings (TRUS), prostate cancer antigen 3 (PCA3), TMPRSS2-ERG gene fusion, CTAGE5-KHDRBS3 gene fusion and USP9Y-TTTY15 gene fusion were collected by prospective analysis from 100 cases who had been performed prostate biopsy with prostate specific antigen lower than 20 ng/mL.Univariable and multivariable logistic regression analysis was used to develop regression model and nomogram. Receiver operating characteristic curve analysis was used to evaluate its predictive accuracy. Results   Five independent predictors of prostate cancer were identified: age, PSA, prostate volume, PCA3 and TMPRSS2-ERG gene fusion. A model topredict prostate biopsy outcome was developed using these five variables. The area under the ROC curve for this model was 0.897. Conclusions   Prostate cancer antigen 3 combined with TMPRSS2-ERG gene fusion can highly improve the accuracy of models to predict prostate biopsy outcome, model which contains new tumor markers can be used to guide decision before prostate biopsy.