实用临床医药杂志2026，Vol.30Issue(16)：47-52,6.DOI:10.7619/jcmp.20262144
老年高级别前列腺癌的多参数列线图预测模型构建与验证
Construction and validation of a multiparameter nomogram prediction model for high-grade prostate cancer in the elderly
摘要
Abstract
Objective To construct and validate a multiparameter nomogram model for predic-ting high-grade prostate cancer in elderly patients with prostate-specific antigen(PSA)levels of 2-20 ng/mL.Methods The clinical data of 390 elderly patients who underwent prostate biopsy were retrospectively analyzed.According to the pathological findings,the patients were divided into high-grade prostate cancer group(n=78)and non-high-grade prostate cancer group(n=312).Baseline clinical characteristics were compared between the two groups.Univariate and multivariate logistic re-gression analyses were used to identify independent predictors of high-grade prostate cancer.Based on the independent predictors,a multiparameter nomogram prediction model was constructed.The dis-criminatory ability and clinical net benefit of the nomogram model were evaluated using receiver operating characteristic(ROC)curve analysis and decision curve analysis,respectively.Results There were sta-tistically significant differences in total prostate-specific antigen(tPSA),free prostate-specific antigen(fPSA),prostate volume(PV),prostate-specific antigen density(PSAD),digital rectal examination(DRE)nodules,transrectal ultrasound(TRUS)hypoechoic lesions,and the proportion of overweight/obese patients(body mass index ≥25 kg/m2)between the two groups(P＜0.05).Univariate and multivariate logistic regression analyses showed that tPSA,fPSA,PV,DRE nodules,TRUS hypoe-choic lesions,and overweight/obesity were independent predictors of high-grade prostate cancer(P＜0.05),based on which the nomogram model was established.The ROC curve showed that the area under the curve(AUC)of the nomogram model was 0.835,which was significantly greater than those of tPSA,the free-to-total PSA ratio(％fPSA),and PSAD(P＜0.05).The calibration curve demonstrated good consistency between the predicted probabilities of the nomogram model and the ac-tual observed rates.Decision curve analysis showed that the nomogram model provided a higher net benefit for predicting high-grade prostate cancer than tPSA,％fPSA,and PSAD.Conclusion The nomogram model constructed based on multiple parameters(tPSA,fPSA,PV,DRE nodules,TRUS hypoechoic lesions,and overweight/obesity)has good predictive value for high-grade prostate cancer in the elderly.关键词
高级别前列腺癌/老年人/前列腺特异性抗原/列线图/预测模型/直肠指检/经直肠超声/体质量指数Key words
high-grade prostate cancer/the elderly/prostate-specific antigen/nomogram/pre-diction model/digital rectal examination/transrectal ultrasound/body mass index分类
医药卫生引用本文复制引用
南力宾,李明敏,霍韶军,王杰,李强,李茹,霍红沙..老年高级别前列腺癌的多参数列线图预测模型构建与验证[J].实用临床医药杂志,2026,30(16):47-52,6.基金项目
河北省医学科学研究课题计划(20210939) （20210939）
