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Prostate ; 67(14): 1524-36, 2007 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-17683063

RESUMO

BACKGROUND: Prostate needle biopsy (PNB) ploidy status has proven utility to predict adverse outcomes after prostatectomy. We sought to develop models to predict ploidy status using clinicopathologic variables. METHODS: We identified a cohort of 169 patients with a diagnosis of prostatic adenocarcinoma on PNB, and estimated ploidy status (determined using Feulgen stained biopsy tissue) using four predictors, including age, prebiopsy PSA, highest Gleason score (GS), and the percentage of involvement by carcinoma at the biopsy site with the highest GS (PCARBX). Logistic regression (LR), Neural Network (NN), and CART classifiers were constructed. RESULTS: Univariate analyses revealed all four predictors to be significantly associated with ploidy status. On multivariable analyses, LR identified a 2-parameter model, including GS and PCARBX that had a significant ability to predict ploidy status with a 74% and 75% correct classification rate (CCR), respectively. Using the same variables, CART and NN yielded similar CCRs of 70.4%. Within GS = 6 cohort, the CART model classified over 90% of biopsies as diploid when patients had a PCARBX < 55% and a log(PSA) < 1.7. CONCLUSIONS: Our study demonstrates that models using GS and PCARBX are able to predict PNB ploidy status with acceptable accuracy. While machine learning classifier-derived models yield similar accuracy as LR-derived models, the latter methodology has the distinct advantage of being applicable in future datasets to estimate case-specific predictions. This information may be useful in identifying potentially aneuploid patients, who can then be targeted for more aggressive therapy.


Assuntos
Adenocarcinoma/genética , Aneuploidia , Redes Neurais de Computação , Neoplasias da Próstata/genética , Adenocarcinoma/sangue , Adenocarcinoma/classificação , Adenocarcinoma/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha , Estudos de Coortes , DNA de Neoplasias/genética , Análise Discriminante , Humanos , Citometria por Imagem , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Valor Preditivo dos Testes , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/classificação , Neoplasias da Próstata/diagnóstico , Medição de Risco
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