{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:39:26Z","timestamp":1793813966280,"version":"4.6.1"},"reference-count":25,"publisher":"Walter de Gruyter GmbH","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_cclm-2023-0008_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Clinical practice guidelines endorse the stratification of prostate cancer (PCa) risk according to individual total prostate-specific antigen (tPSA) values and age to enhance the individual risk-benefit ratio. We defined two nomograms to predict the individual risk of high and low grade PCa by combining the assay of tPSA and %free\/tPSA (%f\/tPSA) in patients with a pre-biopsy tPSA between 2 and 10\u00a0\u03bcg\/L.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2023-0008_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The study cohort consisted of 662 patients that had fPSA, tPSA, and a biopsy performed (41.3% with a final diagnosis of PCa). Logistic regression including age, tPSA and %f\/tPSA was used to model the probability of having high or low grade cancer by defining 3 outcome levels: no PCa, low grade (International Society of Urological Pathology grade, ISUP&lt;3) and high grade PCa (ISUP\u22653).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2023-0008_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The nomogram identifying patients with: (a)\u00a0high vs. those with low grade PCa and without the disease showed a good discriminating capability (\u223c80%), but the calibration showed a risk of underestimation for predictive probabilities &gt;30% (a considerable critical threshold of risk), (b)\u00a0ISUP&lt;3 vs. those without the disease showed a\u00a0discriminating capability of 63% and overestimates predictive probabilities &gt;50%. In ISUP 5 a possible loss of PSA immunoreactivity has been observed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2023-0008_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The estimated risk of high or low grade PCa by\u00a0the nomograms may be of aid in the decision-making process, in particular in the case of critical comorbidities and\u00a0when the digital rectal examinations are inconclusive. The improved characterization of the risk of ISUP\u22653 might enhance the use for magnetic resonance imaging in this setting.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/cclm-2023-0008","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T08:59:31Z","timestamp":1674809971000},"page":"1327-1334","source":"Crossref","is-referenced-by-count":30,"title":["Individual risk prediction of high grade prostate cancer based on the combination between total prostate-specific antigen (PSA) and free to total PSA ratio"],"prefix":"10.1515","volume":"61","author":[{"given":"Simona","family":"Ferraro","sequence":"first","affiliation":[{"name":"Center of Functional Genomics and Rare Diseases, Department of Pediatrics , Buzzi Children\u2019s Hospital , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Biganzoli","sequence":"additional","affiliation":[{"name":"Medical Statistics Unit, Department of Biomedical and Clinical Sciences , \u201cLuigi Sacco\u201d University Hospital, Universit\u00e0 degli Studi di Milano , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta Simona","family":"Rossi","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Anatomia Patologica , ASST Fatebenefratelli-Sacco, Ospedale \u2018Luigi Sacco\u2019 , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Palmisano","sequence":"additional","affiliation":[{"name":"Urologia , ASST Fatebenefratelli-Sacco, Ospedale \u2018Luigi Sacco\u2019 , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Bussetti","sequence":"additional","affiliation":[{"name":"Immunoematologia e Medicina trasfusionale Ospedale Castelli , Verbania , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrica","family":"Verzotti","sequence":"additional","affiliation":[{"name":"Urologia , ASST Fatebenefratelli-Sacco, Ospedale \u2018Luigi Sacco\u2019 , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Gregori","sequence":"additional","affiliation":[{"name":"Urologia , ASST Fatebenefratelli-Sacco, Ospedale \u2018Luigi Sacco\u2019 , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Anatomia Patologica , ASST Fatebenefratelli-Sacco, Ospedale Fatebenefratelli , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Maggioni","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Anatomia Patologica , Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0958-5354","authenticated-orcid":false,"given":"Ferruccio","family":"Ceriotti","sequence":"additional","affiliation":[{"name":"Laboratorio Analisi , Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Cereda","sequence":"additional","affiliation":[{"name":"Center of Functional Genomics and Rare Diseases, Department of Pediatrics , Buzzi Children\u2019s Hospital , Milan , Italy"},{"name":"Pediatric Department , Buzzi Children\u2019s Hospital , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianvincenzo","family":"Zuccotti","sequence":"additional","affiliation":[{"name":"Pediatric Department , Buzzi Children\u2019s Hospital , Milan , Italy"},{"name":"Department of Biomedical and Clinical Science , University of Milan , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kavsak","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Medicine , McMaster University , Hamilton , ON , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0270-1711","authenticated-orcid":false,"given":"Mario","family":"Plebani","sequence":"additional","affiliation":[{"name":"Department of Medicine-DIMED , University of Padova , Padova , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Marano","sequence":"additional","affiliation":[{"name":"Medical Statistics Unit, Department of Biomedical and Clinical Sciences , \u201cLuigi Sacco\u201d University Hospital, Universit\u00e0 degli Studi di Milano , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elia Mario","family":"Biganzoli","sequence":"additional","affiliation":[{"name":"Medical 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