Role of hK2, Free PSA, and Complexed PSA Measurements in the Very Early Detection of Prostate Cancer

Introduction: Total PSA (tPSA) and free PSA (fPSA) are the most commonly used biomarkers for early detection of prostate cancer. Despite standardization efforts, many available PSA assays may still produce discordant results. In the present study, we compared four PSA assays calibrated to the WHO standards 96/670 and 96/668 for tPSA and fPSA, respectively. Methods: Within the scope of the Prostate Cancer Early Detection Study Based on a ‘‘Baseline’’ PSA Value in Young Men (PROBASE), we tested tPSA and fPSA in serum samples from 50 patients in the four different PROBASE sites using four WHO-calibrated assays from Roche (Elecsys, Cobas), Beckman-Coulter (Access-II) and Siemens (ADVIA Centaur). The comparison was performed using the Passing–Bablok regression method. Results: Compared to Access, the median tPSA levels for Centaur, Elecsys, and Cobas were +3%, +11%–20%, and +17%–23%, respectively, while for median fPSA levels the differences for Centaur, Elecsys, and Cobas were +49%, +29%–31%, and +22%, respectively. Discussion: Despite all investigated assays being WHO-calibrated, the Elecsys and Cobas tPSA assays produced considerably higher results than the Access and Centaur assays. Differences in fPSA-recovery between all investigated assays were even more pronounced. When applying the tPSA cutoff of 3.1 μg/L recommended for WHO-calibrated assays, the use of higher calibrated assays may lead to unnecessary prostate biopsies. Conversely, if the historical threshold of 4 μg/L is applied when using WHO-calibrated assays, it could lead to falsely omitted prostate biopsies.

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Role of multiparametric magnetic resonance imaging in early detection of prostate cancer

Insights into Imaging ◽

10.1007/s13244-016-0466-9 ◽

2016 ◽

Vol 7 (2) ◽

pp. 205-214 ◽

Cited By ~ 25

Author(s):

Pieter J. L. De Visschere ◽

Alberto Briganti ◽

Jurgen J. Fütterer ◽

Pirus Ghadjar ◽

Hendrik Isbarn ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Magnetic Resonance ◽

Early Detection ◽

Resonance Imaging ◽

Multiparametric Magnetic Resonance Imaging

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The Role of Free PSA in the Detection of Prostate Cancer

Laboratory Medicine ◽

10.1309/06e3-4lg5-kyeg-fgac ◽

2001 ◽

Vol 32 (5) ◽

pp. 259-263 ◽

Cited By ~ 4

Author(s):

Paula C. Southwick

Keyword(s):

Prostate Cancer ◽

Free Psa

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Novel Artificial Neural Network for Early Detection of Prostate Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2002.20.4.921 ◽

2002 ◽

Vol 20 (4) ◽

pp. 921-929 ◽

Cited By ~ 55

Author(s):

Bob Djavan ◽

Mesut Remzi ◽

Alexandre Zlotta ◽

Christian Seitz ◽

Peter Snow ◽

...

Keyword(s):

Prostate Cancer ◽

Early Detection ◽

Roc Curve ◽

Predictive Accuracy ◽

Specific Antigen ◽

Psa Density ◽

Free Psa ◽

Ann Models ◽

Artificial Neural ◽

Total Psa

PURPOSE: Two artificial neural networks (ANN) for the early detection of prostate cancer in men with total prostate-specific antigen (PSA) levels from 2.5 to 4 ng/mL and from 4 to 10 ng/mL were prospectively developed. The predictive accuracy of the ANN was compared with that obtained by use of conventional statistical analysis of standard PSA parameters. PATIENTS AND METHODS: Consecutive men with a serum total PSA level between 4 and 10 ng/mL (n = 974) and between 2.5 and 4 ng/mL (n = 272) were analyzed. A separate ANN model was developed for each group of patients. Analyses were performed to determine the presence of prostate cancer. RESULTS: The area under the receiver operator characteristic (ROC) curve (AUC) was 87.6% and 91.3% for the 2.5 to 4 ng/mL and 4 to 10 ng/mL ANN models, respectively. For the latter model, the AUC generated by the ANN was significantly higher than that produced by the single variables of total PSA, percentage of free PSA, PSA density of the transition zone (TZ), and TZ volume (P < .01), but not significantly higher compared with multivariate analysis. For the 2.5 to 4 ng/mL model, the AUC of the ANN ROC curve was significantly higher than the AUCs for percentage of free PSA (P = .0239), PSA-TZ (P = .0204), and PSA density and total prostate volume (P < .01 for both). CONCLUSION: The predictive accuracy of the ANN was superior to that of conventional PSA parameters. ANN models might change the way patients referred for early prostate cancer detection are counseled regarding the need for prostate biopsy.

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Role of Prostate Volume in the Early Detection of Prostate Cancer in a Cohort with Slowly Increasing Prostate Specific Antigen

Yonsei Medical Journal ◽

10.3349/ymj.2013.54.5.1202 ◽

2013 ◽

Vol 54 (5) ◽

pp. 1202 ◽

Cited By ~ 3

Author(s):

Young Min Kim ◽

Sungchan Park ◽

June Kim ◽

Seonghun Park ◽

Ji Ho Lee ◽

...

Keyword(s):

Prostate Cancer ◽

Early Detection ◽

Prostate Specific Antigen ◽

Prostate Volume ◽

Specific Antigen

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Role of Estrogen Metabolism in the Initiation of Prostate Cancer: Biomarkers of Susceptibility and Early Detection

10.21236/ada416725 ◽

2003 ◽

Author(s):

Ercole L. Cavalieri

Keyword(s):

Prostate Cancer ◽

Early Detection ◽

Cancer Biomarkers ◽

Estrogen Metabolism

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MP42-06 EARLY DETECTION OF PROSTATE CANCER RECURRENCE FOLLOWING RADICAL PROSTATECTOMY: THE ROLE OF 18F-CHOLINE PET/CT

The Journal of Urology ◽

10.1016/j.juro.2014.02.1183 ◽

2014 ◽

Vol 191 (4S) ◽

Author(s):

Giuseppe Simone ◽

Giovanni Battista ◽

Di Pierro ◽

Carlo Ludovico Maini ◽

Rocco Papalia ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Early Detection ◽

Cancer Recurrence ◽

Choline Pet ◽

Pet Ct ◽

Prostate Cancer Recurrence

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Biomarkers for prostate cancer: prostate-specific antigen and beyond

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2019-0693 ◽

2020 ◽

Vol 58 (3) ◽

pp. 326-339 ◽

Cited By ~ 6

Author(s):

Michael J. Duffy

Keyword(s):

Prostate Cancer ◽

Prostate Specific Antigen ◽

Ad Hoc ◽

Parp Inhibitor ◽

Specific Antigen ◽

Predictive Biomarkers ◽

Response To Therapy ◽

Average Risk ◽

Free Psa

AbstractIn recent years, several new biomarkers supplementing the role of prostate-specific antigen (PSA) have become available for men with prostate cancer. Although widely used in an ad hoc manner, the role of PSA in screening asymptomatic men for prostate cancer is controversial. Several expert panels, however, have recently recommended limited PSA screening following informed consent in average-risk men, aged 55–69 years. As a screening test for prostate cancer however, PSA has limited specificity and leads to overdiagnosis which in turn results in overtreatment. To increase specificity and reduce the number of unnecessary biopsies, biomarkers such as percent free PSA, prostate health index (PHI) or the 4K score may be used, while Progensa PCA3 may be measured to reduce the number of repeat biopsies in men with a previously negative biopsy. In addition to its role in screening, PSA is also widely used in the management of patients with diagnosed prostate cancer such as in surveillance following diagnosis, monitoring response to therapy and in combination with both clinical and histological criteria in risk stratification for recurrence. For determining aggressiveness and predicting outcome, especially in low- or intermediate-risk men, tissue-based multigene tests such as Decipher, Oncotype DX (Prostate), Prolaris and ProMark, may be used. Emerging therapy predictive biomarkers include AR-V7 for predicting lack of response to specific anti-androgens (enzalutamide, abiraterone), BRAC1/2 mutations for predicting benefit from PARP inhibitor and PORTOS for predicting benefit from radiotherapy. With the increased availability of multiple biomarkers, personalised treatment for men with prostate cancer is finally on the horizon.

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