Evaluation of Prostate-Specific Antigen Isoform p2PSA and Its Derivates, %p2PSA, Prostate Health Index and Prostate Dimension-Adjusted Related Index in the Detection of Prostate Cancer at First Biopsy: An Exploratory, Prospective Study

2014 ◽  
Vol 93 (2) ◽  
pp. 135-145 ◽  
Author(s):  
Luigi Mearini ◽  
Carla Ferri ◽  
Massimo Lazzeri ◽  
Vittorio Bini ◽  
Elisabetta Nunzi ◽  
...  
Author(s):  
Manuel M. Garrido ◽  
José C. Marta ◽  
Rui M. Bernardino ◽  
João Guerra ◽  
Francisco Fernandes ◽  
...  

Context.— There is a need to avoid the overdiagnosis of prostate cancer (PCa) and to find more specific biomarkers. Objective.— To evaluate the clinical utility of [−2]pro–prostate-specific antigen ([−2]proPSA) derivatives in detecting clinically significant PCa (csPCa) and to compare it with prostate-specific antigen (PSA) and with the percentage of free PSA (%fPSA). Design.— Two hundred thirty-seven men (PSA: 2–10 ng/mL) scheduled for a prostate biopsy were enrolled. Parametric and nonparametric tests, receiver operating characteristic (ROC) curves, and logistic regression analysis were applied. Outcomes were csPCa and overall PCa. Results.— Both [−2]proPSA derivatives were significantly higher in csPCa and overall PCa (P < .001). The areas under the curves for the prediction of csPCa were higher for the percentage of [−2]proPSA (%[−2]proPSA) (0.781) and the prostate health index (PHI) (0.814) than for PSA (0.651) and %fPSA (0.724). There was a gain of 11% in diagnostic accuracy when %[−2]proPSA or PHI were added to a base model with PSA and %fPSA. Twenty-five percent to 29% of biopsies could have been spared with %[−2]proPSA (cutoff: ≥1.25%) and PHI (cutoff: ≥27), missing 10% of csPCa's. The same results could have been achieved by using [−2]proPSA as a reflex test, when %fPSA was 25% or less (cutoffs: ≥1.12% and ≥24 for %[−2]proPSA and PHI, respectively). Conclusions.— The [−2]proPSA derivatives improve the diagnostic accuracy of csPCa, when the PSA value is between 2 and 10 ng/mL, allowing to spare unnecessary biopsies and to select patients for active surveillance. [−2]proPSA can be used as a reflex test when %fPSA is 25% or less, without reducing the diagnostic accuracy for csPCa and the number of spared biopsies.


2017 ◽  
Vol 32 (4) ◽  
pp. 275-283
Author(s):  
Safana S. Al Saidi ◽  
Nafila B. Al Riyami ◽  
Mohammed S. Al Marhoon ◽  
Mohammed S. Al Saraf ◽  
Salim S. Al Busaidi ◽  
...  

2016 ◽  
Vol 15 (13) ◽  
pp. e1562 ◽  
Author(s):  
A. Sanchis-Bonet ◽  
N. Morales-Palacios ◽  
M. Barrionuevo-González ◽  
L.E. Ortega-Polledo ◽  
J.C. Tamayo-Ruiz ◽  
...  

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