{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:33:54Z","timestamp":1787772834405,"version":"build-2784847793"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Here, we developed a prostate cancer (PCa) risk nomogram including lymphocyte-to-monocyte ratio (LMR) for initial prostate biopsy, and internal and external validation were further conducted. A prediction model was developed on a training set. Significant risk factors with\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.10 in multivariate logistic regression models were used to generate a nomogram. Discrimination, calibration, and clinical usefulness of the model were assessed using C-index, calibration plot, and decision curve analysis (DCA). The nomogram was re-examined with the internal and external validation set. A nomogram predicting PCa risk in patients with prostate-specific antigen (PSA) 4\u201310 ng ml\n                      <jats:sup>\u22121<\/jats:sup>\n                      was also developed. The model displayed good discrimination with C-index of 0.830 (95% confidence interval [CI]: 0.812\u20130.852). High C-index of 0.864 (95% CI: 0.840\u20130.888) and 0.871 (95% CI: 0.861\u20130.881) was still reached in the internal and external validation sets, respectively. The nomogram exhibited better performance compared to the nomogram with PSA only (C-index: 0.763, 95% CI: 0.746\u20130.780,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and the nomogram with LMR excluded (C-index: 0.824, 95% CI: 0.804\u20130.844,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.010). The calibration curve demonstrated good agreement in the internal and external validation sets. DCA showed that the nomogram was useful at the threshold probability of &gt;4% and &lt;99%. The nomogram predicting PCa risk in patients with PSA 4\u201310 ng ml\n                      <jats:sup>\u22121<\/jats:sup>\n                      also displayed good calibration and discrimination performance (C-index: 0.734, 95% CI: 0.708\u20130.760). This nomogram incorporating age, PSA, digital rectal examination, abnormal imaging signals, PSA density, and LMR could be used to facilitate individual PCa risk prediction in initial prostate biopsy.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aja.aja_19_20","type":"journal-article","created":{"date-parts":[[2020,6,5]],"date-time":"2020-06-05T03:15:07Z","timestamp":1591326907000},"page":"41-46","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Development and validation of a nomogram including lymphocyte-to-monocyte ratio for initial prostate 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