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Serum isoform [-2]proPSA derivatives significantly improve prediction of prostate cancer at initial biopsy in a total PSA range of 2-10 ng/ml: a multicentric European study

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Serum isoform [-2]proPSA derivatives significantly improve prediction of prostate cancer at initial biopsy in a total PSA range of 2-10 ng/ml: a multicentric European study. / Lazzeri, Massimo; Haese, Alexander; de la Taille, Alexandre; Palou Redorta, Joan; McNicholas, Thomas; Lughezzani, Giovanni; Scattoni, Vincenzo; Bini, Vittorio; Freschi, Massimo; Sussman, Amy; Ghaleh, Bijan; Le Corvoisier, Philippe; Alberola Bou, Josep; Esquena Fernández, Salvador; Graefen, Markus; Guazzoni, Giorgio.

In: EUR UROL, Vol. 63, No. 6, 01.06.2013, p. 986-94.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Lazzeri, M, Haese, A, de la Taille, A, Palou Redorta, J, McNicholas, T, Lughezzani, G, Scattoni, V, Bini, V, Freschi, M, Sussman, A, Ghaleh, B, Le Corvoisier, P, Alberola Bou, J, Esquena Fernández, S, Graefen, M & Guazzoni, G 2013, 'Serum isoform [-2]proPSA derivatives significantly improve prediction of prostate cancer at initial biopsy in a total PSA range of 2-10 ng/ml: a multicentric European study', EUR UROL, vol. 63, no. 6, pp. 986-94. https://doi.org/10.1016/j.eururo.2013.01.011

APA

Lazzeri, M., Haese, A., de la Taille, A., Palou Redorta, J., McNicholas, T., Lughezzani, G., Scattoni, V., Bini, V., Freschi, M., Sussman, A., Ghaleh, B., Le Corvoisier, P., Alberola Bou, J., Esquena Fernández, S., Graefen, M., & Guazzoni, G. (2013). Serum isoform [-2]proPSA derivatives significantly improve prediction of prostate cancer at initial biopsy in a total PSA range of 2-10 ng/ml: a multicentric European study. EUR UROL, 63(6), 986-94. https://doi.org/10.1016/j.eururo.2013.01.011

Vancouver

Lazzeri M, Haese A, de la Taille A, Palou Redorta J, McNicholas T, Lughezzani G et al. Serum isoform [-2]proPSA derivatives significantly improve prediction of prostate cancer at initial biopsy in a total PSA range of 2-10 ng/ml: a multicentric European study. EUR UROL. 2013 Jun 1;63(6):986-94. https://doi.org/10.1016/j.eururo.2013.01.011

Bibtex

@article{30edce0c200b4a64b13b16198ac012bc,
title = "Serum isoform [-2]proPSA derivatives significantly improve prediction of prostate cancer at initial biopsy in a total PSA range of 2-10 ng/ml: a multicentric European study",
abstract = "BACKGROUND: Strategies to reduce prostate-specific antigen (PSA)-driven prostate cancer (PCa) overdiagnosis and overtreatment seem to be necessary.OBJECTIVE: To test the accuracy of serum isoform [-2]proPSA (p2PSA) and its derivatives, percentage of p2PSA to free PSA (fPSA; %p2PSA) and the Prostate Health Index (PHI)-called index tests-in discriminating between patients with and without PCa.DESIGN, SETTING, AND PARTICIPANTS: This was an observational, prospective cohort study of patients from five European urologic centers with a total PSA (tPSA) range of 2-10 ng/ml who were subjected to initial prostate biopsy for suspected PCa.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary end point was to evaluate the specificity, sensitivity, and diagnostic accuracy of index tests in determining the presence of PCa at prostate biopsy in comparison to tPSA, fPSA, and percentage of fPSA to tPSA (%fPSA) (standard tests) and the number of prostate biopsies that could be spared using these tests. Multivariable logistic regression models were complemented by predictive accuracy analysis and decision curve analysis.RESULTS AND LIMITATIONS: Of >646 patients, PCa was diagnosed in 264 (40.1%). Median tPSA (5.7 vs 5.8 ng/ml; p=0.942) and p2PSA (15.0 vs 14.7 pg/ml) did not differ between groups; conversely, median fPSA (0.7 vs 1 ng/ml; p<0.001), %fPSA (0.14 vs 0.17; p<0.001), %p2PSA (2.1 vs 1.6; p<0.001), and PHI (48.2 vs 38; p<0.001) did differ significantly between men with and without PCa. In multivariable logistic regression models, p2PSA, %p2PSA, and PHI significantly increased the accuracy of the base multivariable model by 6.4%, 5.6%, and 6.4%, respectively (all p<0.001). At a PHI cut-off of 27.6, a total of 100 (15.5%) biopsies could have been avoided. The main limitation is that cases were selected on the basis of their initial tPSA values.CONCLUSIONS: In patients with a tPSA range of 2-10 ng/ml, %p2PSA and PHI are the strongest predictors of PCa at initial biopsy and are significantly more accurate than tPSA and %fPSA.",
keywords = "Adenocarcinoma, Aged, Biopsy, Cohort Studies, Diagnostic Errors, Humans, Kallikreins, Logistic Models, Male, Middle Aged, Multivariate Analysis, Predictive Value of Tests, Prospective Studies, Prostate, Prostate-Specific Antigen, Prostatic Neoplasms, Protein Precursors, ROC Curve, Tumor Markers, Biological",
author = "Massimo Lazzeri and Alexander Haese and {de la Taille}, Alexandre and {Palou Redorta}, Joan and Thomas McNicholas and Giovanni Lughezzani and Vincenzo Scattoni and Vittorio Bini and Massimo Freschi and Amy Sussman and Bijan Ghaleh and {Le Corvoisier}, Philippe and {Alberola Bou}, Josep and {Esquena Fern{\'a}ndez}, Salvador and Markus Graefen and Giorgio Guazzoni",
note = "Copyright {\textcopyright} 2013 European Association of Urology. Published by Elsevier B.V. All rights reserved.",
year = "2013",
month = jun,
day = "1",
doi = "10.1016/j.eururo.2013.01.011",
language = "English",
volume = "63",
pages = "986--94",
journal = "EUR UROL",
issn = "0302-2838",
publisher = "Elsevier",
number = "6",

}

RIS

TY - JOUR

T1 - Serum isoform [-2]proPSA derivatives significantly improve prediction of prostate cancer at initial biopsy in a total PSA range of 2-10 ng/ml: a multicentric European study

AU - Lazzeri, Massimo

AU - Haese, Alexander

AU - de la Taille, Alexandre

AU - Palou Redorta, Joan

AU - McNicholas, Thomas

AU - Lughezzani, Giovanni

AU - Scattoni, Vincenzo

AU - Bini, Vittorio

AU - Freschi, Massimo

AU - Sussman, Amy

AU - Ghaleh, Bijan

AU - Le Corvoisier, Philippe

AU - Alberola Bou, Josep

AU - Esquena Fernández, Salvador

AU - Graefen, Markus

AU - Guazzoni, Giorgio

N1 - Copyright © 2013 European Association of Urology. Published by Elsevier B.V. All rights reserved.

PY - 2013/6/1

Y1 - 2013/6/1

N2 - BACKGROUND: Strategies to reduce prostate-specific antigen (PSA)-driven prostate cancer (PCa) overdiagnosis and overtreatment seem to be necessary.OBJECTIVE: To test the accuracy of serum isoform [-2]proPSA (p2PSA) and its derivatives, percentage of p2PSA to free PSA (fPSA; %p2PSA) and the Prostate Health Index (PHI)-called index tests-in discriminating between patients with and without PCa.DESIGN, SETTING, AND PARTICIPANTS: This was an observational, prospective cohort study of patients from five European urologic centers with a total PSA (tPSA) range of 2-10 ng/ml who were subjected to initial prostate biopsy for suspected PCa.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary end point was to evaluate the specificity, sensitivity, and diagnostic accuracy of index tests in determining the presence of PCa at prostate biopsy in comparison to tPSA, fPSA, and percentage of fPSA to tPSA (%fPSA) (standard tests) and the number of prostate biopsies that could be spared using these tests. Multivariable logistic regression models were complemented by predictive accuracy analysis and decision curve analysis.RESULTS AND LIMITATIONS: Of >646 patients, PCa was diagnosed in 264 (40.1%). Median tPSA (5.7 vs 5.8 ng/ml; p=0.942) and p2PSA (15.0 vs 14.7 pg/ml) did not differ between groups; conversely, median fPSA (0.7 vs 1 ng/ml; p<0.001), %fPSA (0.14 vs 0.17; p<0.001), %p2PSA (2.1 vs 1.6; p<0.001), and PHI (48.2 vs 38; p<0.001) did differ significantly between men with and without PCa. In multivariable logistic regression models, p2PSA, %p2PSA, and PHI significantly increased the accuracy of the base multivariable model by 6.4%, 5.6%, and 6.4%, respectively (all p<0.001). At a PHI cut-off of 27.6, a total of 100 (15.5%) biopsies could have been avoided. The main limitation is that cases were selected on the basis of their initial tPSA values.CONCLUSIONS: In patients with a tPSA range of 2-10 ng/ml, %p2PSA and PHI are the strongest predictors of PCa at initial biopsy and are significantly more accurate than tPSA and %fPSA.

AB - BACKGROUND: Strategies to reduce prostate-specific antigen (PSA)-driven prostate cancer (PCa) overdiagnosis and overtreatment seem to be necessary.OBJECTIVE: To test the accuracy of serum isoform [-2]proPSA (p2PSA) and its derivatives, percentage of p2PSA to free PSA (fPSA; %p2PSA) and the Prostate Health Index (PHI)-called index tests-in discriminating between patients with and without PCa.DESIGN, SETTING, AND PARTICIPANTS: This was an observational, prospective cohort study of patients from five European urologic centers with a total PSA (tPSA) range of 2-10 ng/ml who were subjected to initial prostate biopsy for suspected PCa.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary end point was to evaluate the specificity, sensitivity, and diagnostic accuracy of index tests in determining the presence of PCa at prostate biopsy in comparison to tPSA, fPSA, and percentage of fPSA to tPSA (%fPSA) (standard tests) and the number of prostate biopsies that could be spared using these tests. Multivariable logistic regression models were complemented by predictive accuracy analysis and decision curve analysis.RESULTS AND LIMITATIONS: Of >646 patients, PCa was diagnosed in 264 (40.1%). Median tPSA (5.7 vs 5.8 ng/ml; p=0.942) and p2PSA (15.0 vs 14.7 pg/ml) did not differ between groups; conversely, median fPSA (0.7 vs 1 ng/ml; p<0.001), %fPSA (0.14 vs 0.17; p<0.001), %p2PSA (2.1 vs 1.6; p<0.001), and PHI (48.2 vs 38; p<0.001) did differ significantly between men with and without PCa. In multivariable logistic regression models, p2PSA, %p2PSA, and PHI significantly increased the accuracy of the base multivariable model by 6.4%, 5.6%, and 6.4%, respectively (all p<0.001). At a PHI cut-off of 27.6, a total of 100 (15.5%) biopsies could have been avoided. The main limitation is that cases were selected on the basis of their initial tPSA values.CONCLUSIONS: In patients with a tPSA range of 2-10 ng/ml, %p2PSA and PHI are the strongest predictors of PCa at initial biopsy and are significantly more accurate than tPSA and %fPSA.

KW - Adenocarcinoma

KW - Aged

KW - Biopsy

KW - Cohort Studies

KW - Diagnostic Errors

KW - Humans

KW - Kallikreins

KW - Logistic Models

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Predictive Value of Tests

KW - Prospective Studies

KW - Prostate

KW - Prostate-Specific Antigen

KW - Prostatic Neoplasms

KW - Protein Precursors

KW - ROC Curve

KW - Tumor Markers, Biological

U2 - 10.1016/j.eururo.2013.01.011

DO - 10.1016/j.eururo.2013.01.011

M3 - SCORING: Journal article

C2 - 23375961

VL - 63

SP - 986

EP - 994

JO - EUR UROL

JF - EUR UROL

SN - 0302-2838

IS - 6

ER -