A novel robust nomogram based on peripheral monocyte counts for predicting lymph node metastasis of prostate cancer

列线图 医学 接收机工作特性 切断 前列腺癌 逻辑回归 多元分析 前列腺特异性抗原 肿瘤科 内科学 放射科 癌症 量子力学 物理
作者
Jiawei Zhou,Yunhua Mao,Yang Liu,Hai‐tao Liang,Chandni Chandur Samtani,Yuewu Fu,Yunlin Ye,Gang Xiao,Zike Qin,Cundong Liu,Jian-Kun Yang,Qi-Zhao Zhou,Wenbin Guo,Kang-Yi Xue,Shan‐Chao Zhao,Ming-Kun Chen
出处
期刊:Asian Journal of Andrology [Medknow]
卷期号:23 (4): 409-414 被引量:2
标识
DOI:10.4103/aja.aja_89_20
摘要

Accurate methods for identifying pelvic lymph node metastasis (LNM) of prostate cancer (PCa) prior to surgery are still lacking. We aimed to investigate the predictive value of peripheral monocyte count (PMC) for LNM of PCa in this study. Two hundred and ninety-eight patients from three centers were divided into a training set (n = 125) and a validation set (n = 173). In the training set, the independent predictors of LNM were analyzed using univariate and multivariate logistic regression analyses, and the optimal cutoff value was calculated by the receiver operating characteristic (ROC) curve. The sensitivity and specificity of the optimal cutoff were authenticated in the validation cohort. Finally, a nomogram based on the PMC was constructed for predicting LNM. Multivariate analyses of the training cohort demonstrated that clinical T stage, preoperative Gleason score, and PMC were independent risk factors for LNM. The subsequent ROC analysis showed that the optimal cutoff value of PMC for diagnosing LNM was 0.405 × 109 l-1 with a sensitivity of 60.0% and a specificity of 67.8%. In the validation set, the optimal cutoff value showed significantly higher sensitivity than that of conventional magnetic resonance imaging (MRI) (0.619 vs 0.238, P < 0.001). The nomogram involving PMC, free prostate-specific antigen (fPSA), clinical T stage, preoperative Gleason score, and monocyte-to-lymphocyte ratio (MLR) was generated, which showed a robust predictive capacity for predicting LNM before the operation. Our results indicated that PMC as a single agent, or combined with other clinical parameters, showed a robust predictive capacity for LNM in PCa. It can be employed as a complementary factor for the decision of whether to conduct pelvic lymph node dissection.
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