(2° pagina) (Torna alla 1° pagina..) significativamente più alto (P <0,01). Il punteggio medio SelectMDx era significativamente più alto nei pazienti con una lesione significativa sospetta su mpMRI rispetto a nessun sospetto di PCa significativo (P<0,01).
Per la previsione del risultato mpMRI, l'area sotto la curva di
SelectMDx era 0,83 rispetto a 0,66 per PSA e 0,65 per PCA3. C'è stata un'associazione positiva tra il punteggio SelectMDx e il voto PI-RADS finale. C'era una differenza statisticamente significativa nel punteggio SelectMDx tra PI-RADS 3 e 4 (P <0,01) e tra PI-RADS 4 e 5 (P <0,01).
I dati indicano che il punteggio SelectMDx è uno strumento valido per il rilevamento del carcinoma prostatico. Il punteggio può aiutare i medici a identificare i pazienti maggiormente a rischio, per poterli poi sottoporre a procedure più invasive come la biopsia. Tutto ciò ridurrebbe in maniera significativa il numero delle procedure non necessarie.

A urinary biomarker-based risk score correlates with multiparametric MRI for prostate cancer detection.
Hendriks RJ, et al. Prostate. 2017.
Abstract
BACKGROUND: Prostate cancer (PCa) diagnostics would greatly benefit from more accurate, non-invasive techniques for the detection of clinically significant disease, leading to a reduction of over-diagnosis and over-treatment. The aim of this study was to determine the association between a novel urinary biomarker-based risk score (SelectMDx), multiparametric MRI (mpMRI) outcomes, and biopsy results for PCa detection.

METHODS: This retrospective observational study used data from the validation study of the SelectMDx score, in which urine was collected after digital rectal examination from men undergoing prostate biopsies.
A subset of these patients also underwent a mpMRI scan of the prostate. The indications for performing mpMRI were based on persistent clinical suspicion of PCa or local staging after PCa was found upon biopsy. All mpMRI images were centrally reviewed in 2016 by an experienced radiologist blinded for the urine test results and biopsy outcome. The
PI-RADS version 2 was used.

RESULTS: In total, 172 patients were included for analysis. Hundred (58%) patients had PCa detected upon prostate biopsy, of which 52 (52%) had high-grade disease correlated with a significantly higher SelectMDx score (P < 0.01). The median SelectMDx score was significantly higher in patients with a suspicious significant lesion on mpMRI compared to no suspicion of significant PCa (P < 0.01). For the prediction of mpMRI outcome, the area-under-the-curve of SelectMDx was 0.83 compared to 0.66 for PSA and 0.65 for PCA3. There was a positive association between SelectMDx score and the final PI-RADS grade. There was a statistically significant difference in SelectMDx score between PI-RADS 3 and 4 (P < 0.01) and between PI-RADS 4 and 5 (P < 0.01).

CONCLUSIONS: The novel urinary biomarker-based SelectMDx score is a promising tool in PCa detection. This study showed promising results regarding the correlation between the SelectMDx score and mpMRI outcomes, outperforming PCA3. Our results suggest that this risk score
could guide clinicians in identifying patients at risk for significant PCa and selecting patients for further radiological diagnostics to reduce unnecessary procedures.
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26/06/2019 Andrea Piccoli


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