Risk score predicts high-grade prostate cancer in DNA-methylation positive, histopathologically negative biopsies.

摘要: BACKGROUND Prostate cancer (PCa) diagnosis is challenging because efforts for effective, timely treatment of men with significant typically result in over-diagnosis and repeat biopsies. The presence or absence epigenetic aberrations, more specifically DNA-methylation GSTP1, RASSF1, APC histopathologically negative prostate core biopsies has resulted an increased predictive value (NPV) ∼90% thus could lead to a reduction unnecessary Here, it investigated whether, methylation-positive men, intensities help identify those harboring high-grade (Gleason score ≥7) PCa, resulting improved positive value. METHODS Two cohorts, consisting index biopsies, followed by biopsy, were combined. EpiScore, methylation intensity algorithm was developed using area under the curve receiver operating characteristic as metric performance. Next, risk score combining EpiScore traditional clinical factors further improve identification Score ≥7) cancer. RESULTS Compared other factors, detection most important predictor cancer, NPV 96%. In significantly higher detected upon compared either no low-grade cancer. improvement patient stratification better currently used metrics PSA prevention trial (PCPT) calculator (RC). A decision analysis indicated strong utility decision-making tool biopsy. CONCLUSIONS Low levels PCa-negative led 96% score, comprising maximum avoidance This outperformed current prediction models such PCPTRC PSA. patients PCa. Prostate 76:1078–1087, 2016. © 2016 Authors. Published Wiley Periodicals, Inc.