Clinical utility of the (-2)proPSA and evaluation of the evidence: a systematic review

Pecoraro, Valentina; Rovedatti, L.; Plebani, Mario; Trenti, Tommaso

doi:10.1515/cclm-2015-0876

Cited by 7 publications

(4 citation statements)

References 33 publications

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“…Interestingly, a low possibility of PCa outcome on biopsy is supplementary to small PHI results, while an elevated possibility of PCa outcome on biopsy is directly related to elevated PHI. Different medical considerations or family history of PCa are dominant factors in the management process as it relates to the appropriate PHI value [70,72,73].…”

Section: Prostate Health Indexmentioning

confidence: 99%

The Clinical Usefulness of Prostate Cancer Biomarkers: Current and Future Directions

McGrowder¹,

Anderson-Jackson²,

Dilworth³

et al. 2022

Biomedical Engineering

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Worldwide, prostate cancer (PCa) is the leading cause of morbidity and cancer-related mortality in men. The pathogenesis of PCa is complex and involves abnormal genetic changes, abrogation of cell growth with heterogeneous progression and predictive subgroups. In the last two decades there have been the exploration and development of molecular and genetic biomarkers for PCa due to limitations of traditional serum biomarkers such as prostate specific antigen (PSA) in screening and diagnosis. These biomarkers could possibly differentiate between PCa and benign prostatic hyperplasia (BPH) patients, and healthy controls as well as assist with prognosis, risk stratification and clinical decision-making. Such molecular biomarkers include serum (PHI and 4K score), urine (PCA3 and SelectMDx), and tumor tissue (Oncoytype DX, Decipher and Prolarix). microRNAs (miRNAs) deregulation where there is increased or decreased expression levels, constitute prospective non-invasive molecular biomarkers for the diagnosis and prognosis of PCa. There are also other emerging molecular biomarkers such as exosomal miRNAs and proteins that are in various stages of development and clinical research. This review is intended to provide a wide-ranging appraisal of the literature on current and emerging PCa biomarkers with robust evidence to afford their application in clinical research and by extension routine clinical practice.

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Section: Prostate Health Indexmentioning

confidence: 99%

The Clinical Usefulness of Prostate Cancer Biomarkers: Current and Future Directions

McGrowder¹,

Anderson-Jackson²,

Dilworth³

et al. 2022

Biomedical Engineering

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“…The Phi test is a better tool for clinically significant PCa identification, than its individual components [5]. A systematic review by Pecoraro et al [20] that included 17 studies with 6,912 patients on Phi concluded that Phi increases the specificity for PCa detection [20]. For p2PSA the authors reported AUC ranging from 0.51 to 0.62, highlighting a better performance for %p2PSA (AUC from 0.63 to 0.78) and Phi (AUC from 0.67 to 0.78) [4,10,19,21,22].…”

Section: Figure 1 Roc Curve Analysismentioning

confidence: 99%

Comparison among different precursor prostatespecific antigen isoform derivatives on prostate cancer prediction in patients with serum prostatespecific antigen bellow 10 ng/ml

et al. 2020

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Introduction/Objective The precursor prostate-specific antigen (proPSA) especially its isoform p2PSA is useful in the detection of prostate cancer (PCa). However, the prediction value of different p2PSA derivatives remains unclear. The aim of the study was to compare the performance of the p2PSA, percentage of p2PSA to free PSA (%p2PSA), prostate health index (Phi), and one prostate dimension-adjusted index, p2PSA density (p2PSAD), with each other for PCa prediction in patients with serum PSA 10 ng/ml or less. Methods This prospective study included patients who had undergone ultrasound-guided prostate biopsies and p2PSA testing. The data about patients' clinicopathological characteristics were collected and %p2PSA, p2PSAD and Phi were calculated. Different aspect of predictive performance was assessed using the area under the receiver operating characteristic curve (AUC), the specificities at set sensitivities, and clinical utility using decision curve analyses (DCA). Results PCa was diagnosed in 23 (32.4%) out of 71 patients. Results of multivariate analysis showed that only the Phi and digital rectal examination were independent predictors of PCa. The AUC of p2PSA, %p2PSA, p2PSAD and Phi were 76.2%, 81.5%, 88.7%, 89.6%, respectively. At pre-specified sensitivity of 90% and 95%, Phi demonstrated a greater specificity than the other p2PSA derivatives. Phi and p2PSAD lead to the higher net benefit in DCA. Conclusion Compared with other p2PSA derivatives Phi is the most useful parameter for selection of the patients that do not need to be undergone to biopsy and thereby avoiding unnecessary procedures.

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“…PHI testing is approved for men at least 50 years old with normal DRE results and PSA values within the gray zone of 4–10 ng/ml. A meta-analyses reported that PHI has higher diagnostic accuracy rates than other PSA derivatives [54]. In addition, studies have demonstrated that these biomarkers have utility in predicting aggressive PCa (defined as Gleason score ≥7) [53▪▪,55–58].…”

Section: Determining the Need For Prostate Biopsymentioning

confidence: 99%

A multiparametric approach to improve upon existing prostate cancer screening and biopsy recommendations

Helfand

Conran

et al. 2017

Current Opinion in Urology

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Purpose of review To provide an overview of how genetic, serum, and urine biomarkers can help identify men at high risk for prostate cancer (PCa) and aggressive disease and men who would benefit from prostate biopsy. Recent findings Screening for PCa is controversial because of concerns about overdiagnosis and overtreatment of nonlife-threatening tumors. Therefore, an approach to screening that includes a detailed family history with genetic testing of risk single nucleotide polymorphisms and high-penetrance genetic variants should be considered. After an elevated serum prostate-specific antigen (PSA) level has been confirmed, obtaining additional information (family history, biomarkers, and imaging) should be considered before recommending a prostate biopsy. Summary There are now genetic tests that can help identify men who would benefit from PSA testing. Additional biomarker and imaging tests should be offered to those men who are confirmed to have elevated PSA values. These new biomarkers and imaging tests can improve the specificity of PSA testing while missing a small percentage of high-grade tumors. The path forward involves a multiparametric risk assessment based on clinical data and these new tests.

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Clinical utility of the (-2)proPSA and evaluation of the evidence: a systematic review

Cited by 7 publications

References 33 publications

The Clinical Usefulness of Prostate Cancer Biomarkers: Current and Future Directions

The Clinical Usefulness of Prostate Cancer Biomarkers: Current and Future Directions

Comparison among different precursor prostatespecific antigen isoform derivatives on prostate cancer prediction in patients with serum prostatespecific antigen bellow 10 ng/ml

A multiparametric approach to improve upon existing prostate cancer screening and biopsy recommendations

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