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

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...

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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
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cited_by cdi_FETCH-LOGICAL-c390t-bb9347d4a774b29879706614adcfeea9b080dab801dcbc6220474b60fb9cf3aa3
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container_title European urology
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creator Raaijmakers, René
de Vries, Stijn H
Blijenberg, Bert G
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Postma, Renske
Bangma, Chris H
Darte, Claude
Schröder, Fritz H
description 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
doi_str_mv 10.1016/j.eururo.2007.04.037
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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 &lt;0.5 ml. Results Sera and tumour volumes from 91 men were available for analysis. Minimal prostate cancer was diagnosed in 16.5% of the selected cases. Mean tumour volume was 1.2 ml (range: 0.04–13.5); hK2, the algorithms hK2/fPSA, and hK2/%fPSA have significant correlations with tumour volume. Both algorithms also yielded the best test results in predicting minimal disease with an area under the receiver operator characteristics curve of 82%. Conclusions hK2 and percent free PSA have added prognostic value for the detection of minimal prostate cancer in screen-detected cases within PSA range 4–10 ng/ml. These biomarkers can possibly be used to select less invasive treatment options like active surveillance and to prevent overtreatment.</description><identifier>ISSN: 0302-2838</identifier><identifier>EISSN: 1873-7560</identifier><identifier>DOI: 10.1016/j.eururo.2007.04.037</identifier><identifier>PMID: 17499425</identifier><identifier>CODEN: EUURAV</identifier><language>eng</language><publisher>Oxford: Elsevier</publisher><subject>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. 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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 &lt;0.5 ml. Results Sera and tumour volumes from 91 men were available for analysis. Minimal prostate cancer was diagnosed in 16.5% of the selected cases. Mean tumour volume was 1.2 ml (range: 0.04–13.5); hK2, the algorithms hK2/fPSA, and hK2/%fPSA have significant correlations with tumour volume. Both algorithms also yielded the best test results in predicting minimal disease with an area under the receiver operator characteristics curve of 82%. Conclusions hK2 and percent free PSA have added prognostic value for the detection of minimal prostate cancer in screen-detected cases within PSA range 4–10 ng/ml. These biomarkers can possibly be used to select less invasive treatment options like active surveillance and to prevent overtreatment.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biomarkers, Tumor - blood</subject><subject>Biopsy - methods</subject><subject>Endosonography</subject><subject>Follow-Up Studies</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Male</subject><subject>Male genital diseases</subject><subject>Mass Screening - methods</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Prognosis</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatectomy - methods</subject><subject>Prostatic Neoplasms - blood</subject><subject>Prostatic Neoplasms - diagnosis</subject><subject>Prostatic Neoplasms - surgery</subject><subject>ROC Curve</subject><subject>Severity of Illness Index</subject><subject>Tissue Kallikreins - blood</subject><subject>Tumors</subject><subject>Tumors of the urinary system</subject><subject>Urinary tract. 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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 &lt;0.5 ml. Results Sera and tumour volumes from 91 men were available for analysis. Minimal prostate cancer was diagnosed in 16.5% of the selected cases. Mean tumour volume was 1.2 ml (range: 0.04–13.5); hK2, the algorithms hK2/fPSA, and hK2/%fPSA have significant correlations with tumour volume. Both algorithms also yielded the best test results in predicting minimal disease with an area under the receiver operator characteristics curve of 82%. Conclusions hK2 and percent free PSA have added prognostic value for the detection of minimal prostate cancer in screen-detected cases within PSA range 4–10 ng/ml. These biomarkers can possibly be used to select less invasive treatment options like active surveillance and to prevent overtreatment.</abstract><cop>Oxford</cop><pub>Elsevier</pub><pmid>17499425</pmid><doi>10.1016/j.eururo.2007.04.037</doi><tpages>7</tpages></addata></record>
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identifier ISSN: 0302-2838
ispartof European urology, 2007-11, Vol.52 (5), p.1358-1364
issn 0302-2838
1873-7560
language eng
recordid cdi_proquest_miscellaneous_68334347
source ScienceDirect Journals
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
title hK2 and Free PSA, a Prognostic Combination in Predicting Minimal Prostate Cancer in Screen-Detected Men within the PSA Range 4–10 ng/ml
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