Evaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy
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Evaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy. / Rajwa, Pawel; Huebner, Nicolai A; Hostermann, Dadjar I; Grossmann, Nico C; Schuettfort, Victor M; Korn, Stephan; Quhal, Fahad; König, Frederik; Mostafaei, Hadi; Laukhtina, Ekaterina; Mori, Keiichiro; Motlagh, Reza Sari; Yanagisawa, Takafumi; Aydh, Abdulmajeed; Bryniarski, Piotr; Pradere, Benjamin; Paradysz, Andrzej; Baltzer, Pascal A; Grubmüller, Bernhard; Shariat, Shahrokh F.
In: J PERS MED, Vol. 11, No. 11, 1231, 19.11.2021.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Evaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy
AU - Rajwa, Pawel
AU - Huebner, Nicolai A
AU - Hostermann, Dadjar I
AU - Grossmann, Nico C
AU - Schuettfort, Victor M
AU - Korn, Stephan
AU - Quhal, Fahad
AU - König, Frederik
AU - Mostafaei, Hadi
AU - Laukhtina, Ekaterina
AU - Mori, Keiichiro
AU - Motlagh, Reza Sari
AU - Yanagisawa, Takafumi
AU - Aydh, Abdulmajeed
AU - Bryniarski, Piotr
AU - Pradere, Benjamin
AU - Paradysz, Andrzej
AU - Baltzer, Pascal A
AU - Grubmüller, Bernhard
AU - Shariat, Shahrokh F
PY - 2021/11/19
Y1 - 2021/11/19
N2 - The aim of this study was to assess the predictive value of pre-biopsy blood-based markers in patients undergoing a fusion biopsy for suspicious prostate magnetic resonance imaging (MRI). We identified 365 consecutive patients who underwent MRI-targeted and systematic prostate biopsy for an MRI scored Prostate Imaging-Reporting and Data System Version (PI-RADS) ≥ 3. We evaluated the neutrophil/lymphocyte ratio (NLR), derived neutrophil/lymphocyte ratio (dNLR), platelet/lymphocyte ratio (PLR), systemic immune inflammation index (SII), lymphocyte/monocyte ratio (LMR,) de Ritis ratio, modified Glasgow Prognostic Score (mGPS), and prognostic nutrition index (PNI). Uni- and multivariable logistic models were used to analyze the association of the biomarkers with biopsy findings. The clinical benefits of biomarkers implemented in clinical decision-making were assessed using decision curve analysis (DCA). In total, 69% and 58% of patients were diagnosed with any prostate cancer and Gleason Grade (GG) ≥ 2, respectively. On multivariable analysis, only high dNLR (odds ratio (OR) 2.61, 95% confidence interval (CI) 1.23-5.56, p = 0.02) and low PNI (OR 0.48, 95% CI 0.26-0.88, p = 0.02) remained independent predictors for GG ≥ 2. The logistic regression models with biomarkers reached AUCs of 0.824-0.849 for GG ≥ 2. The addition of dNLR and PNI did not enhance the net benefit of a standard clinical model. Finally, we created the nomogram that may help guide biopsy avoidance in patients with suspicious MRI. In patients with PI-RADS ≥ 3 lesions undergoing MRI-targeted and systematic biopsy, a high dNLR and low PNI were associated with unfavorable biopsy outcomes. Pre-biopsy blood-based biomarkers did not, however, significantly improve the discriminatory power and failed to add a clinical benefit beyond standard clinical factors.
AB - The aim of this study was to assess the predictive value of pre-biopsy blood-based markers in patients undergoing a fusion biopsy for suspicious prostate magnetic resonance imaging (MRI). We identified 365 consecutive patients who underwent MRI-targeted and systematic prostate biopsy for an MRI scored Prostate Imaging-Reporting and Data System Version (PI-RADS) ≥ 3. We evaluated the neutrophil/lymphocyte ratio (NLR), derived neutrophil/lymphocyte ratio (dNLR), platelet/lymphocyte ratio (PLR), systemic immune inflammation index (SII), lymphocyte/monocyte ratio (LMR,) de Ritis ratio, modified Glasgow Prognostic Score (mGPS), and prognostic nutrition index (PNI). Uni- and multivariable logistic models were used to analyze the association of the biomarkers with biopsy findings. The clinical benefits of biomarkers implemented in clinical decision-making were assessed using decision curve analysis (DCA). In total, 69% and 58% of patients were diagnosed with any prostate cancer and Gleason Grade (GG) ≥ 2, respectively. On multivariable analysis, only high dNLR (odds ratio (OR) 2.61, 95% confidence interval (CI) 1.23-5.56, p = 0.02) and low PNI (OR 0.48, 95% CI 0.26-0.88, p = 0.02) remained independent predictors for GG ≥ 2. The logistic regression models with biomarkers reached AUCs of 0.824-0.849 for GG ≥ 2. The addition of dNLR and PNI did not enhance the net benefit of a standard clinical model. Finally, we created the nomogram that may help guide biopsy avoidance in patients with suspicious MRI. In patients with PI-RADS ≥ 3 lesions undergoing MRI-targeted and systematic biopsy, a high dNLR and low PNI were associated with unfavorable biopsy outcomes. Pre-biopsy blood-based biomarkers did not, however, significantly improve the discriminatory power and failed to add a clinical benefit beyond standard clinical factors.
U2 - 10.3390/jpm11111231
DO - 10.3390/jpm11111231
M3 - SCORING: Journal article
C2 - 34834583
VL - 11
JO - J PERS MED
JF - J PERS MED
SN - 2075-4426
IS - 11
M1 - 1231
ER -
