scholarly journals A new “ASAP Scoring System and Risk Table” to predict second prostate biopsy outcomes

2021 ◽  
Author(s):  
Caner Ediz ◽  
Serkan Akan ◽  
Neslihan Kaya Terzi ◽  
Aysenur Ihvan
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Roc Curve ◽  
Scoring System ◽  
Area Under The Curve ◽  
Roc Curve Analysis ◽  
Atypical Small Acinar Proliferation ◽  
Risk Patients ◽  
The Mean ◽  
New Criteria

IntroductionThis study aimed to discuss the necessity of a second prostate biopsy in patients with atypical small acinar proliferation (ASAP) and to develop a scoring system and risk table to be used as new criteria for a second biopsy.Material and methodsThe study reviewed the data of 2,845 patients; who underwent transrectal ultrasonography-guided prostate biopsy in the period between January 2008 and May 2019. A total of 128 patients with ASAP were included in the study. The tPSA, fPSA, f/tPSA, and PSA-Density levels before the first and second biopsies and changes in the measured levels between the values obtained before the first and the second biopsies were recorded. “ASAP Scoring System and risk table” (ASS-RT) was evaluated before the second biopsy.ResultsThe mean age of 128 patients with ASAP was 62.9±7.8 years. The ASS-RT scores of prostate cancer patients were significantly higher compared to patients without prostate cancer (p: 0.001). In the ROC curve analysis of ASS-RT, the area under the curve was 0.804 and the standard error was 0.04. The area under the ROC curve was significantly higher than 0.5 (p:0.001). The cut-off point of ASS-RT scores in diagnosing cancer was ≥ 7 with 60.8% sensitivity and 80.5% specificityConclusionsThe cut-off value of 7 determined for the ASS-RT score in this study suggests that patients with ASS-RT scores of ≥7 should undergo a second prostate biopsy. We think that there may be no need for a second biopsy if the ASS-RT score is <7, especially for low-risk patients.

scholarly journals A new “ASAP Scoring System and Risk Table” in patients with Atypical Small Acinar Proliferation (ASAP) to predict the second prostate biopsy outcomes

2021 ◽  
Author(s):  
Caner Ediz ◽  
Serkan Akan ◽  
Neslihan Kaya Terzi ◽  
Aysenur Ihvan
Keyword(s):  
Prostate Biopsy ◽  
Roc Curve ◽  
Scoring System ◽  
Risk Group ◽  
Area Under The Curve ◽  
Threshold Value ◽  
Roc Curve Analysis ◽  
Atypical Small Acinar Proliferation ◽  
The Mean ◽  
Density Assessment

Background: To discuss the necessity of the second prostate biopsy in the patients with atypical small acinar proliferation (ASAP) and to develop a scoring system and risk table as a new re-biopsy criteria. Methods: 2845 patients who were performed transrectal ultrasonography-guided prostate biopsy between January 2008 and May 2019 were evaluated. 128 patients, whose data were reached, were enrolled into the study. Before the first and the second biopsy, tPSA, fPSA, f/tPSA rate and PSA-Density assessment and changes in these parameters between the two biopsies were recorded. “ASAP Scoring System and risk table” (ASS-RT) was evaluated before the second biopsy. Results: The mean age of 128 patients with ASAP was 62.9±7.8 years. The ASS-RT scores of the patients with PCa were statistically significantly higher than the patients with non-PCa (p: 0.001). In the ROC curve analysis of ASS-RT, area under the curve was 0.804 and the standard error was 0.04. The area under the ROC curve was significantly higher than 0.5 (p:0.001). The cut-off point of ASS-RT score in diagnosis of malignancy was ≥ 7. The sensitivity of this value was found to be 60.8% and its specificity as 80.5%. Conclusions: The threshold value for the ASS-RT score may be used as 7 and the second biopsy may be performed immediately to patients over this value. We think that there may be no need for a second biopsy if the ASS-RT score under the 7 (especially low-risk group) before the second biopsy.

scholarly journals APTIMA PCA3 Molecular Urine Test: Development of a Method to Aid in the Diagnosis of Prostate Cancer

2006 ◽  
Vol 52 (6) ◽  
pp. 1089-1095 ◽  
Author(s):  
Jack Groskopf ◽  
Sheila MJ Aubin ◽  
Ina Lim Deras ◽  
Amy Blase ◽  
Sharon Bodrug ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Prostate Cancer Risk ◽  
Area Under The Curve ◽  
Roc Curve Analysis ◽  
Cancer Risk Factors ◽  
Specimen Processing ◽  
Whole Urine

Abstract Background: Prostate cancer gene 3 (PCA3) encodes a prostate-specific mRNA that has shown promise as a prostate cancer diagnostic tool. This report describes the characterization of a prototype quantitative PCA3-based test for whole urine. Methods: Whole-urine specimens were collected after digital rectal examination from 3 groups: men scheduled for prostate biopsy (n = 70), healthy men (&lt;45 years of age with no known prostate cancer risk factors; n = 52), and men who had undergone radical prostatectomy (n = 21). PCA3 and prostate-specific antigen (PSA) mRNAs were isolated, amplified, and quantified by use of Gen-Probe DTS400® Systems. Prostate biopsy results were correlated with the PCA3/PSA mRNA ratio, and PSA mRNA concentrations were used to normalize PCA3 signals and confirm the yield of prostate-specific RNA. Assay precision, specimen stability, and mRNA yield were also evaluated. Results: The specimen informative rate (fraction of specimens yielding sufficient RNA for analysis) was 98.2%. In this clinical research study, ROC curve analysis of prebiopsy specimens yielded an area under the curve of 0.746; sensitivity was 69% and specificity 79%. Serum PSA assay specificity was 28% for this same group. PCA3 and PSA mRNAs were undetectable in postprostatectomy specimens except for one man with recurrent prostate cancer. Assay interrun CVs were ≤12%. Both mRNAs were stable in processed urine up to 5 days at 4 °C and after 5 freeze–thaw cycles. Conclusion: The APTIMA® PCA3 assay combines simple specimen processing with precise assays and existing instruments and could add specificity to the current algorithm for prostate cancer diagnosis.

scholarly journals Evaluation of prediction score of contrast-induced nephropathy in inpatients undergone to digital or CT angiography

2020 ◽  
Vol 10 (3) ◽  
pp. 78-84
Author(s):  
Seleno Glauber de Jesus-Silva ◽  
Ana Elisa Chaves ◽  
Caio Augusto Alves Maciel ◽  
Edson Eziel Ferreira Scotini ◽  
Pablo Girardelli Mendonça Mesquita ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Roc Curve ◽  
Computed Tomography Angiography ◽  
Score Test ◽  
Area Under The Curve ◽  
Roc Curve Analysis ◽  
Contrast Induced Nephropathy ◽  
Mean Values ◽  
Iodinated Contrast ◽  
The Mean

Objectives: To assess the incidence of contrast-induced nephropathy (CIN) and determine the Mehran Score's (MS) ability to predict CIN in patients undergoing digital angiography or computed tomography angiography. Methods: 252 medical records of inpatients who underwent DA or CTA over 28 months in a quaternary hospital were reviewed. CIN was defined as serum creatinine> 0.5 mg / dL or > 25% increase in baseline creatinine, 48 h after administration of iodinated contrast. The ROC curve and the area under the curve (AUC) were used as a score test. Results: The majority (159; 63.1%) were male, and the average age was 60.4 years. Anemia, diabetes mellitus, and age > 75 years were the most prevalent factors. The incidence of CIN was 17.8% (n = 45). There was a decrease in the mean values ​​of creatinine pre and post among patients who did not suffer CIN (1.38 ± 1.22 vs 1.19 ± 0.89; t = 3.433; p = 0.0007), while among patients who suffering CIN, the mean increase was 1.03 mg / dL (1.43 ± 1.48 vs 2.46 ± 2.35 mg / dL; t = 5.44; p = 0.117). The ROC curve analysis identified a low correlation between MS and the occurrence of CIN (AUC = 0.506). Conclusion: The incidence of CIN in hospitalized patients undergoing angiography or computed tomography angiography was high. The EM did not allow the prediction of NIC.

Gestational Age as a Predictor of Pregnancy Outcome After Repeat Cerclage

2021 ◽  
Author(s):  
Benshuo Cai ◽  
Xinni Na
Keyword(s):  
Survival Rate ◽  
Pregnancy Outcome ◽  
Gestational Age ◽  
Roc Curve ◽  
Univariate Analysis ◽  
Area Under The Curve ◽  
Roc Curve Analysis ◽  
Kaplan Meier ◽  
Significant Difference ◽  
The Mean

Abstract Background: The role of repeat cerclage (RC) as a remedy for patients with prolapsed membranes after prior cerclage remains controversial. We aimed to investigate whether gestational age (GA) could be used as a valuable factor for predicting pregnancy outcome following RC in women with prolapsed membranes after prior cerclage. Methods: We retrospectively investigated the clinical data of 29 patients who underwent RC resulting from prolapsed membrane after prior cerclage. Receiving operating characteristic (ROC) curve analysis and univariate analysis were performed to determine predictive factors. Patients were divided into two groups according to GA at RC, GA<24.2 weeks and GA≥24.2 weeks. Pregnancy outcomes were compared between groups.Results: The mean GA at prior cerclage was 16.5 weeks; mean GA at RC was 23.6 weeks. The mean GA at delivery was 27.8 weeks with a 69.0% neonatal survival rate. ROC curve and univariate analysis demonstrated that GA at RC was significantly predictive for neonatal survival (area under the curve: 0.928; p=0.000). Using a GA cut-off of ≥24.2 weeks at RC, the sensitivity and specificity of predicting neonatal survival were 93.75% and 61.54%, respectively. There was a significant difference in neonatal survival rate between the GA <24.2 weeks group and GA ≥24.2 weeks group (38.5% vs. 93.8%, p=0.003). Kaplan–Meier survival curves showed a lower incidence of neonatal death in the GA ≥24.2 weeks group (6.3%) compared with GA <24.2 weeks group (61.5%, p=0.023).Conclusions: GA could be a valuable factor for predicting pregnancy outcome post-RC in women with prolapsed membrane after prior cerclage.

Side Scatter Level of Main Populations in Peripheral Blood using Flow Cytometry as a Tool for the Screening/Detection of Dysplasia and Its Utility in the Diagnosis of Myelodysplastic Syndromes

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5091-5091
Author(s):  
Ekaterina Rusanova ◽  
Ramon Simon-Lopez
Keyword(s):  
Flow Cytometry ◽  
Myelodysplastic Syndromes ◽  
Roc Curve ◽  
Statistical Significance ◽  
Area Under The Curve ◽  
Curve Analysis ◽  
Control Group ◽  
Roc Curve Analysis ◽  
Significance Level ◽  
The Mean

Abstract The myelodysplastic syndromes (MDS) are a group of clonal bone marrow disorders characterized by peripheral cytopenias, ineffective hematopoiesis, and unilineage or multilineage dysplasia. The feature used commonly for the diagnostic of MDS includes several morphological cell characteristics such as the presence of hypogranulation in the neutrophils. We have observed in our daily experience at the Mean Scatter of neutrophils was lower in MDS than in normal cases. We have observed that Lymphocyte scatter is quite constant in normal cases and in the majority of MDS. 11 patients diagnosed with MDS and 16 normal blood donors as a control group were enrolled into this study. The protocol of study included evaluation of blood cell populations by hematological analyzer GenS (BC), smears microscopy and flow cytometry for identification a level of granularity of neutrophils (FC500, BC). We created a single tube protocol for immunophenotyping of blood cells by multiparametric flow cytometry using a panel of monoclonal antibodies: CD14-FITC, CD16-PE, CD33-PC5 and CD45-PC7 (BC). We isolated the neutrophil and the lymphocyte populations by subsequent gating steps according to FS/SS, CD45/SS, CD45/CD16 and CD33/CD14. After gating, we measured the Mean Side Scatter in lymphocytes and neutrophils. In order to standardize the NE Mean Scatter we used also a ratio that was calculated by dividing the Neutrophil Mean Scatter by Lymphocyte Mean Scatter. Descriptive Statistics Mean Scatter n Mean SD Median Normals 16 633.6 99.7 612 MDS 11 564.4 83.1 543 Comparative Statistics Normals vs MDS T-test Mean differences ROC AUC ROC cut-off sensitivity specificity sign. ROC Mean NE Scatter 0.071 69.11 0.685 &lt;=543 54.5 87.5 0.0732 Ratio NES/LYS 0.016 2.175 0.824 &lt;=8.34 81.82 81.25 0.0001 The results show the consistent differences between the Neutrophil Mean Scatter in the MDS group compared with the normals with a p =0.07 near the level of statistical significance. The Ratio between Mean Scatter of Neutrophils and the Mean Scatter of Lymphocytes (Ratio NE S/LY S) was significantly lower in MDS than in the group of normals (p=0.016). The ROC Curve analysis using the Neutrophil Mean Scatter to detect/flag MDS showed an acceptable area under the curve AUC=0.685 (significance level 0.073) with a cut-off of &lt;=533 we obtain a sensitivity of 54.5% with a specificity of 87.5%. The ROC Curve analysis using the Ratio NE S/LY S to detect/flag MDS have shown a good area under the curve AUC=0.824 (significance level 0.0001) with a cut-off of &lt;=8.34 we obtain a sensitivity of 81.8% with a specificity of 81.2%. The fact about hypogranularity of the neutrophils is a well known feature of MDS. Using the Neutrophil Mean Scatter and the Ratio between Mean Scatter of Neutrophils and the Mean Scatter of Lymphocytes may be useful tool to detect or flag the neutrophil hypogranularity and will permit to help in the differential diagnosis of MDS. These data are numerical, quantitative and objective. It will be necessary to increase the number of cases (MDS) and to include other hematologic malignancies in order to see the specificity of this findings compared with other diseases.

scholarly journals Modified zwolle score with delta-creatinine: enhancing the safety of early discharge after STEMI

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Bras ◽  
J Pais ◽  
M Carrington ◽  
A.R Rocha ◽  
B Picarra ◽  
...  
Keyword(s):  
Roc Curve ◽  
Roc Curves ◽  
Early Discharge ◽  
Early Mortality ◽  
Curve Analysis ◽  
Low Risk ◽  
Roc Curve Analysis ◽  
C Statistic ◽  
Risk Patients ◽  
The Mean

Abstract Introduction The Zwolle score (ZS) is recommended to identify low-risk patients eligible for early discharge after acute ST-segment elevation myocardial infarction (STEMI), but as only one-third of STEMIs have a low ZS, the discharge is often postponed. Creatinine variation (Δ-Cr) also provide prognostic information after STEMI. Purpose The authors intend to study the “modified Zwolle Score” (MZS) model, which encompasses Δ-Cr as a variable that may enhance the discriminative power of the standard ZS. The outcome is 30-day mortality, time range that starts right after the ACS. Methods This is a retrospective study with data from a national multicentre registry. We have included 3.296 patients with STEMI. Zwolle score was calculated for each patient. It is defined as shown in figure 1. Δ-Cr was defined as maximum serum creatinine minus admission serum creatinine. A Δ-Cr≥0.3 was assigned 2 points in the Modified Zwolle Score, after interpretation of odds ratio via multivariate analysis. For prediction quality assessment, we have performed ROC curve analysis with both scoring systems versus 30-day mortality. Regarding survival analysis, we have performed Kaplan-Meier curves with Log-rank analysis. We have also registered complications during hospital stay. Results The sample mean age is 63±14, and it is composed by 76.8% of males. The majority of patients presented Killip Class I (87.3%). The STEMI was anterior in 49.7% of patients and inferior in 49.8% of patients. The mean admission time was 5 days. Intrahospital mortality was 3% and 30-day mortality was 4%. The mean ZS was 3.1±2.8 points, the mean MZS was 3±2.1 points and the mean Δ-Cr was 0.2±0.6mg/dL. The ROC curve analysis between ZS and early mortality revealed a c-statistic of 0.810 (CI 0.796–0.823), whereas the ROC curve between MZS and early mortality revealed a c-statistic of 0.853 (95% CI: 0.841–0.865). The ROC curves comparison showed superiority of the MZS c-statistic, with a difference between AUC of 0.043 (p&lt;0.001, 95% CI: 0.024–0.063). Regarding low-risk patients, 30-day mortality was 3.3% using ZS (0–2 points) and 2.4% using modified ZS (0–2 points). Fifty patients (1.5%) died between 3rd and 10th day after ACS: original ZS low-risk criteria registered 0.09% and modified ZS low-risk criteria 0.06% fatalities. Kappa coefficient for intergroup concordance was good (0.73). Conclusion We conclude that by adding Δ-Cr to the standard ZS, a renal function parameter that was lacking in the ZS, its predicting capacity regarding early mortality in patients admitted with STEMI was increased. Comparing both scores, low-risk patients defined by MZS registered less complications, 3–10 day mortality and 30-day mortality than low-risk patients defined by the original ZS. This fact may lead to better distinction of patients who will benefit from early discharge. Zwolle Score, ROC curves and survival Funding Acknowledgement Type of funding source: None

scholarly journals Is There a Role for Prostate Tumour Overexpressed-1 in the Diagnosis of HGPIN and of Prostatic Adenocarcinoma? A Comparison with α-Methylacyl CoA Racemase

2012 ◽  
Vol 25 (1) ◽  
pp. 67-74 ◽  
Author(s):  
M. Scarpelli ◽  
R. Mazzucchelli ◽  
F. Barbisan ◽  
A. Santinelli ◽  
A. Lopez-Beltran ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Differential Display ◽  
Roc Curve ◽  
Intraepithelial Neoplasia ◽  
Prostatic Intraepithelial Neoplasia ◽  
Curve Analysis ◽  
High Grade ◽  
Roc Curve Analysis ◽  
Prostate Tumour

Prostate Tumour Overexpressed-1 (PTOV1) was recently identified as a novel gene and protein during a differential display screening for genes overexpressed in prostate cancer (PCa). α-Methyl-CoA racemose (AMACR) mRNA was identified as being overexpressed in PCa. PTOV1 and racemase were immunohistochemically evaluated in PCa, high-grade prostatic intraepithelial neoplasia (HGPIN), atrophy and normal-looking epithelium (NEp) in 20 radical prostatectomies (RPs) with pT2a Gleason score 6 prostate cancer with the aim of analyzing the differences in marker expression between PTOV1 and AMACR. The level of expression of PTOV1 and AMACR increased from NEp and atrophy through HGPIN, away from and adjacent to prostate cancer, to PCa. With the ROC curve analysis the overall accuracy in distinguishing PCa vs HGPIN away from and adjacent to cancer was higher for AMACR than for PTOV1. In conclusion, AMACR can be considered a more accurate marker than PTOV1 in the identification of HGPIN and of PCa. However, PTOV1 may aid in the diagnosis of PCa, at least to supplement AMACR as another positive marker of carcinoma and to potentially increase diagnostic accuracy.

scholarly journals Development and validation of a prognostic model to predict clinical deterioration in hospitalized patients with COVID-19

2021 ◽  
Author(s):  
Javid Azadbakht ◽  
Sina Rashedi ◽  
Soheil Kooraki ◽  
Hamed Kowsari ◽  
Elnaz Tabibian
Keyword(s):  
Roc Curve ◽  
Scoring System ◽  
Prognostic Model ◽  
Operating Characteristic ◽  
Clinical Laboratory ◽  
External Validation ◽  
Clinical Deterioration ◽  
Roc Curve Analysis ◽  
Prospective Multicenter Study ◽  
Development And Validation

Abstract Objectives We aimed to develop and validate a prognostic model to predict clinical deterioration defined as either death or intensive care unit admission of hospitalized COVID-19 patients.Methods This prospective, multicenter study investigated 172 consecutive hospitalized COVID-19 patients who underwent a chest computed tomography (CT) scan between March 20 and April 30, 2020 (development cohort), as well as an independent sample of 40 consecutive patients for external validation (validation cohort). The clinical, laboratory, and radiologic data were gathered, and logistic regression along with receiver operating characteristic (ROC) curve analysis was performed.Results The overall clinical deterioration rates of the development and validation cohorts were 28.4% (49 of 172) and 30% (12 of 40), respectively. Seven predictors were included in the scoring system with a total score of 15: CT severity score\(\ge\)15 (Odds Ratio (OR)=6.34, 4 points), pleural effusion (OR = 6.80, 2 points), symptom onset to admission ≤ 6 days (OR = 2.44, 2 points), age\(\ge\)70 years (OR = 2.44, 2 points), diabetes mellitus (OR = 2.24, 2 points), dyspnea (OR = 2.17, 1.5 points), and abnormal leukocyte count (OR = 1.89, 1.5 points). The area under the ROC curve for the scoring system in the development and validation cohorts was 0.823 (CI [0.751–0.895]) and 0.558 (CI [0.340–0.775]), respectively.Conclusion This study provided a new easy-to-calculate scoring system with external validation for hospitalized COVID-19 patients to predict clinical deterioration based on a combination of seven clinical, laboratory, and radiologic parameters.

scholarly journals Diagnostic accuracy of prostate cancer antigen 3 (PCA3) prior to first prostate biopsy: A systematic review and meta-analysis

2019 ◽  
Vol 14 (5) ◽  
Author(s):  
Sandra Viviana Muñoz Rodríguez ◽  
Herney Andrés García-Perdomo
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Prostate Biopsy ◽  
Reference Lists ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Cancer Antigen ◽  
Prostate Cancer Antigen

Introduction: We aimed to determine the diagnostic accuracy of the prostate cancer antigen 3 (PCA3) test before performing the first biopsy compared with prostate biopsy for the diagnosis of prostate cancer. Methods: A systematic search was performed in MEDLINE, EMBASE, CENTRAL, LILACS, reference lists, specialized journals in urology and cancer, and unpublished literature. The population was adults with suspected prostate cancer, and the intervention was the measurement of PCA3 in urine samples for the diagnosis of prostate cancer. The quality of studies was evaluated with the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. The operative characteristics were determined, and a meta-analysis was performed. Results: Nine studies of diagnostic tests were included based on a cutoff value of 35. The following overall values were obtained: the sensitivity was 0.69 (95% confidence interval [CI] 0.61–0.75); specificity was 0.65 (95% CI 0.553–0.733); the diagnostic odds ratio (DOR) was 4.244 (95% CI 3.487–5.166); and the area under the curve was 0.734 (95% CI 0.674–0.805) with a heterogeneity of 0%. Conclusions: Urinary PCA3 has an acceptable diagnostic accuracy, aids in the study of patients with suspected prostate cancer, and can be used as a guide for directing the performance of the first prostate biopsy and decreasing unnecessary biopsies.

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