{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T04:46:06Z","timestamp":1782794766260,"version":"3.54.5"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>PSA screening has limited specificity in the 10\u201320 ng\/mL range, making biopsy decisions difficult. Metabolic disorders and inflammation may improve risk prediction. We aimed to develop a model integrating multidimensional indicators to predict prostate cancer and high\u2212grade disease in men with tPSA &amp;gt;10 ng\/mL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included 461 men who underwent prostate biopsy (tPSA &amp;gt;10 ng\/mL). Patients were randomly split into training (70%) and validation (30%) sets. Two logistic regression models were built: Model 1 for benign vs. malignant; Model 2 (in malignant cases) for high\u2212grade (ISUP \u22653) vs. low\u2212grade. Variables with VIF&amp;gt;5 were excluded. Backward stepwise (AIC) and univariate\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.05 guided variable selection. Performance was assessed by AUC, calibration, DCA, and compared with fPSA% alone using DeLong test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>\n                      Among 461 patients, 252 (54.7%) had prostate cancer, and 139 (55.2% of malignant cases) had high\u2212grade disease. Malignant patients were older, had higher BMI, TyG index, NLR, and tPSA, and lower fPSA% (all\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.05). High\u2212grade patients showed similar metabolic differences but no tPSA difference versus low\u2212grade. Model 1 retained age, TyG index, NLR, fPSA%, smoking, hypertension, and lesion location. Model 2 retained age, TyG index, LDH, and smoking history. Validation AUC was 0.871 for Model 1 and 0.779 for Model 2. At optimal thresholds, sensitivity\/specificity were 80.3%\/74.6% (Model 1) and 71.7%\/62.1% (Model 2). Both models showed good calibration (Hosmer\u2212Lemeshow P&amp;gt;0.05). Decision curve analysis and DeLong test confirmed that each full model provided higher net benefit than fPSA% alone (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Two nomograms using routine clinical and laboratory variables may assist in risk stratification for prostate cancer and high\u2212grade disease in men with tPSA &amp;gt;10 ng\/mL, outperforming fPSA% alone. These tools can help reduce unnecessary biopsies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1883224","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T04:24:32Z","timestamp":1782793472000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of multidimensional nomograms for predicting prostate cancer risk: a retrospective study"],"prefix":"10.3389","volume":"16","author":[{"given":"Tao","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junsong","family":"Zeng","sequence":"additional","affiliation":[{"name":"West China School of Medicine and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maosen","family":"Xu","sequence":"additional","affiliation":[{"name":"Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Tie","sequence":"additional","affiliation":[{"name":"Department of Biotherapy, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA: A Cancer J For Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1057\/s41271-024-00502-4","article-title":"PSA screening for prostate cancer in the United States: 30 years of controversy","volume":"45","author":"Georgiou","year":"2024","journal-title":"J Public Health Policy"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.03.027","article-title":"EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on prostate cancer-2024 update. 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