We evaluated the clinical performance of [-2]proPSA (p2PSA) and its derivatives in predicting the presence and aggressiveness of prostate cancer (PCa) in Korean men.
A total of 246 men with total prostate-specific antigen (tPSA) ≥ 3. 5 ng/mL who underwent their first prostate biopsy were included in this prospective, multicenter, observational study. Diagnostic accuracy of tPSA, free-to-total PSA ratio (%fPSA), p2PSA, %p2PSA, and the Beckman Coulter prostate health index (PHI) was assessed by receiver operating characteristic curve analyses and logistic regression analyses.
Overall, PCa was detected in 125 (50.8%) subjects. In men with tPSA 3.5-10 ng/mL, the detection rate of PCa was 39.4% (61/155). In this group, PHI and %p2PSA were the most accurate predictors of PCa and significantly outperformed tPSA and %fPSA; area under the curve for tPSA, %fPSA, %p2PSA, and PHI was 0.56, 0.69, 0.74, and 0.76, respectively. PHI was also the strongest predictor of PCa with Gleason score ≥ 7.
This study demonstrates the superior clinical performance of %p2PSA and PHI in predicting the presence and aggressiveness of PCa in Korean men. The %p2PSA and PHI appear to improve detection of PCa and provide prognostic information.
Journal of Korean medical science. 2018 Mar 12*** epublish ***
Hongzoo Park, Sang Wook Lee, Geehyun Song, Tae Wook Kang, Jae Hung Jung, Hyun Chul Chung, Sung Jin Kim, Chang Hoo Park, Jong Yeon Park, Tae Young Shin, In Bum Suh, Jeong Hyun Kim
Department of Urology, Kangwon National University School of Medicine, Chuncheon, Korea., Department of Urology, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea., Department of Urology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea., Department of Urology, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea., Department of Clinical Diagnosis, Kangwon National University School of Medicine, Chuncheon, Korea., Department of Urology, Kangwon National University School of Medicine, Chuncheon, Korea. .