Evaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy

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 scor...

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Autores principales:	Pawel Rajwa, Nicolai A. Huebner, Dadjar I. Hostermann, Nico C. Grossmann, Victor M. Schuettfort, Stephan Korn, Fahad Quhal, Frederik König, Hadi Mostafaei, Ekaterina Laukhtina, Keiichiro Mori, Reza Sari Motlagh, Takafumi Yanagisawa, Abdulmajeed Aydh, Piotr Bryniarski, Benjamin Pradere, Andrzej Paradysz, Pascal A. Baltzer, Bernhard Grubmüller, Shahrokh F. Shariat
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	MRI biopsy dNLR NLR PNI prostate cancer Medicine R
Acceso en línea:	https://doaj.org/article/a688377a57c94ce69a02f88c43f80cd4
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spelling	oai:doaj.org-article:a688377a57c94ce69a02f88c43f80cd42021-11-25T18:08:12ZEvaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy10.3390/jpm111112312075-4426https://doaj.org/article/a688377a57c94ce69a02f88c43f80cd42021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4426/11/11/1231https://doaj.org/toc/2075-4426The 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, <i>p</i> = 0.02) and low PNI (OR 0.48, 95% CI 0.26–0.88, <i>p</i> = 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.Pawel RajwaNicolai A. HuebnerDadjar I. HostermannNico C. GrossmannVictor M. SchuettfortStephan KornFahad QuhalFrederik KönigHadi MostafaeiEkaterina LaukhtinaKeiichiro MoriReza Sari MotlaghTakafumi YanagisawaAbdulmajeed AydhPiotr BryniarskiBenjamin PradereAndrzej ParadyszPascal A. BaltzerBernhard GrubmüllerShahrokh F. ShariatMDPI AGarticleMRIbiopsydNLRNLRPNIprostate cancerMedicineRENJournal of Personalized Medicine, Vol 11, Iss 1231, p 1231 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	MRI biopsy dNLR NLR PNI prostate cancer Medicine R
spellingShingle	MRI biopsy dNLR NLR PNI prostate cancer Medicine R Pawel Rajwa Nicolai A. Huebner Dadjar I. Hostermann Nico C. Grossmann Victor M. Schuettfort Stephan Korn Fahad Quhal Frederik König Hadi Mostafaei Ekaterina Laukhtina Keiichiro Mori Reza Sari Motlagh Takafumi Yanagisawa Abdulmajeed Aydh Piotr Bryniarski Benjamin Pradere Andrzej Paradysz Pascal A. Baltzer Bernhard Grubmüller Shahrokh F. Shariat Evaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy
description	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, <i>p</i> = 0.02) and low PNI (OR 0.48, 95% CI 0.26–0.88, <i>p</i> = 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.
format	article
author	Pawel Rajwa Nicolai A. Huebner Dadjar I. Hostermann Nico C. Grossmann Victor M. Schuettfort Stephan Korn Fahad Quhal Frederik König Hadi Mostafaei Ekaterina Laukhtina Keiichiro Mori Reza Sari Motlagh Takafumi Yanagisawa Abdulmajeed Aydh Piotr Bryniarski Benjamin Pradere Andrzej Paradysz Pascal A. Baltzer Bernhard Grubmüller Shahrokh F. Shariat
author_facet	Pawel Rajwa Nicolai A. Huebner Dadjar I. Hostermann Nico C. Grossmann Victor M. Schuettfort Stephan Korn Fahad Quhal Frederik König Hadi Mostafaei Ekaterina Laukhtina Keiichiro Mori Reza Sari Motlagh Takafumi Yanagisawa Abdulmajeed Aydh Piotr Bryniarski Benjamin Pradere Andrzej Paradysz Pascal A. Baltzer Bernhard Grubmüller Shahrokh F. Shariat
author_sort	Pawel Rajwa
title	Evaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy
title_short	Evaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy
title_full	Evaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy
title_fullStr	Evaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy
title_full_unstemmed	Evaluation of the Predictive Role of Blood-Based Biomarkers in the Context of Suspicious Prostate MRI in Patients Undergoing Prostate Biopsy
title_sort	evaluation of the predictive role of blood-based biomarkers in the context of suspicious prostate mri in patients undergoing prostate biopsy
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/a688377a57c94ce69a02f88c43f80cd4
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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

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