hK2 and Free PSA, a Prognostic Combination in Predicting Minimal Prostate Cancer in Screen-Detected Men within the PSA Range 4–10 ng/ml

• Published in: European urology 2007-11, Vol.52 (5), p.1358-1364
• Main Authors: Raaijmakers, René, de Vries, Stijn H, Blijenberg, Bert G, Wildhagen, Mark F, Postma, Renske, Bangma, Chris H, Darte, Claude, Schröder, Fritz H
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Biomarkers, Tumor - blood; Biopsy - methods; Endosonography; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Male; Male genital diseases; Mass Screening - methods; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Prognosis; Prostate-Specific Antigen - blood; Prostatectomy - methods; Prostatic Neoplasms - blood; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - surgery; ROC Curve; Severity of Illness Index; Tissue Kallikreins - blood; Tumors; Tumors of the urinary system; Urinary tract. Prostate gland; Urology
• ISSN: 0302-2838; 1873-7560
• DOI: 10.1016/j.eururo.2007.04.037

Abstract Objectives The purpose of screening for prostate cancer is to decrease the disease-specific mortality. However not every screen-detected prostate cancer is a threat to the patient's life. The risk of overdetection and subsequent overtreatment in prostate cancer has been recognised. The purpose of this investigation was to evaluate the role of tumour markers total PSA, free PSA, and hK2, and their combinations in predicting minimal prostate cancer. Methods Within the European Randomized Study of Screening for Prostate Cancer (ERSPC), section Rotterdam, The Netherlands, prebiopsy serum samples were analysed for 100 selected men who underwent a radical prostatectomy for their screen-detected prostate cancer. All had a PSA value between 4 and 10 ng/ml prior to diagnosis. Minimal prostate cancer is defined as organ confined, Gleason score ≤6 (no Gleason grade 4 or 5), and tumour volume