BACKGROUND: Prostate health index (phi) and prostate cancer antigen 3 (PCA3) have been recently proposed as novel biomarkers for prostate cancer (PCa). We assessed the diagnostic performance of these biomarkers, alone or in combination, in men undergoing first prostate biopsy for suspicion of PCa. METHODS: One hundred sixty male subjects were enrolled in this prospective observational study. PSA molecular forms, phi index (Beckman coulter immunoassay), PCA3 score (Progensa PCA3 assay), and other established biomarkers (tPSA, fPSA, and %fPSA) were assessed before patients underwent a 18-core first prostate biopsy. The discriminating ability between PCa-negative and PCa-positive biopsies of Beckman coulter phi and PCA3 score and other used biomarkers were determined. RESULTS: One hundred sixty patients met inclusion criteria. %p2PSA (p2PSA/fPSA × 100), phi and PCA3 were significantly higher in patients with PCa compared to PCa-negative group (median values: 1.92 vs. 1.55, 49.97 vs. 36.84, and 50 vs. 32, respectively, P ≤ 0.001). ROC curve analysis showed that %p2PSA, phi, and PCA3 are good indicator of malignancy (AUCs = 0.68, 0.71, and 0.66, respectively). A multivariable logistic regression model consisting of both the phi index and PCA3 score allowed to reach an overall diagnostic accuracy of 0.77. Decision curve analysis revealed that this "combined" marker achieved the highest net benefit over the examined range of the threshold probability. CONCLUSIONS: phi and PCA3 showed no significant difference in the ability to predict PCa diagnosis in men undergoing first prostate biopsy. However, diagnostic performance is significantly improved by combining phi and PCA3.
BACKGROUND: Prostate health index (phi) and prostate cancer antigen 3 (PCA3) have been recently proposed as novel biomarkers for prostate cancer (PCa). We assessed the diagnostic performance of these biomarkers, alone or in combination, in men undergoing first prostate biopsy for suspicion of PCa. METHODS: One hundred sixty male subjects were enrolled in this prospective observational study. PSA molecular forms, phi index (Beckman coulter immunoassay), PCA3 score (Progensa PCA3 assay), and other established biomarkers (tPSA, fPSA, and %fPSA) were assessed before patients underwent a 18-core first prostate biopsy. The discriminating ability between PCa-negative and PCa-positive biopsies of Beckman coulter phi and PCA3 score and other used biomarkers were determined. RESULTS: One hundred sixty patients met inclusion criteria. %p2PSA (p2PSA/fPSA × 100), phi and PCA3 were significantly higher in patients with PCa compared to PCa-negative group (median values: 1.92 vs. 1.55, 49.97 vs. 36.84, and 50 vs. 32, respectively, P ≤ 0.001). ROC curve analysis showed that %p2PSA, phi, and PCA3 are good indicator of malignancy (AUCs = 0.68, 0.71, and 0.66, respectively). A multivariable logistic regression model consisting of both the phi index and PCA3 score allowed to reach an overall diagnostic accuracy of 0.77. Decision curve analysis revealed that this "combined" marker achieved the highest net benefit over the examined range of the threshold probability. CONCLUSIONS: phi and PCA3 showed no significant difference in the ability to predict PCa diagnosis in men undergoing first prostate biopsy. However, diagnostic performance is significantly improved by combining phi and PCA3.
Authors: Jack Cuzick; Mangesh A Thorat; Gerald Andriole; Otis W Brawley; Powel H Brown; Zoran Culig; Rosalind A Eeles; Leslie G Ford; Freddie C Hamdy; Lars Holmberg; Dragan Ilic; Timothy J Key; Carlo La Vecchia; Hans Lilja; Michael Marberger; Frank L Meyskens; Lori M Minasian; Chris Parker; Howard L Parnes; Sven Perner; Harry Rittenhouse; Jack Schalken; Hans-Peter Schmid; Bernd J Schmitz-Dräger; Fritz H Schröder; Arnulf Stenzl; Bertrand Tombal; Timothy J Wilt; Alicja Wolk Journal: Lancet Oncol Date: 2014-10 Impact factor: 41.316
Authors: Marianne Schmid; Quoc-Dien Trinh; Markus Graefen; Margit Fisch; Felix K Chun; Jens Hansen Journal: World J Urol Date: 2014-05-14 Impact factor: 4.226
Authors: Matteo Ferro; Dario Bruzzese; Sisto Perdonà; Ada Marino; Claudia Mazzarella; Giuseppe Perruolo; Vittoria D'Esposito; Vincenzo Cosimato; Carlo Buonerba; Giuseppe Di Lorenzo; Gennaro Musi; Ottavio De Cobelli; Felix K Chun; Daniela Terracciano Journal: PLoS One Date: 2013-07-04 Impact factor: 3.240