3 years ago

Association of [−2]proPSA with Biopsy Reclassification During Active Surveillance for Prostate Cancer

Previous studies have suggested an association between [−2]proPSA expression and prostate cancer detection. Less is known about the usefulness of this marker in following patients with prostate cancer on active surveillance. Thus, we examined the relationship between [−2]proPSA and biopsy results in men enrolled in an active surveillance program. Materials and Methods In 167 men from our institutional active surveillance program we used Cox proportional hazards models to examine the relationship between [−2]proPSA and annual surveillance biopsy results. The outcome of interest was biopsy reclassification (Gleason score 7 or greater, more than 2 positive biopsy cores or more than 50% involvement of any core with cancer). We also examined the association of biopsy results with total prostate specific antigen, %fPSA, [−2]proPSA/%fPSA and the Beckman Coulter Prostate Health Index phi ([−2]proPSA/free prostate specific antigen) × (total prostate specific antigen)½). Results While on active surveillance (median time from diagnosis 4.3 years), 63 (37.7%) men demonstrated biopsy reclassification based on the previously mentioned criteria, including 28 (16.7%) of whom had reclassification based on Gleason score upgrading (Gleason score 7 or greater). Baseline and longitudinal %fPSA, %[−2]proPSA, [−2]proPSA/%fPSA and phi measurements were significantly associated with biopsy reclassification, and %[−2]proPSA and phi provided the greatest predictive accuracy for high grade cancer. Conclusions In men on active surveillance, measures based on [−2]proPSA such as phi appear to provide improved prediction of biopsy reclassification during followup. Additional validation is warranted to determine whether clinically useful thresholds can be defined, and to better characterize the role of %[−2]proPSA and phi in conjunction with other markers in monitoring patients enrolled in active surveillance.

Publisher URL: www.sciencedirect.com/science

DOI: S0022534712039195

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.