Effect of Body mass index on the performance characteristics of PSA-related markers to detect prostate cancer

Abstract

To examine whether the predictive performance of prostate-specific antigen (PSA) and PSA-related markers for prostate cancer (PCa) is modified by body mass index (BMI). Patients with a PSA 2–10 ng/mL who underwent multicore prostate biopsies were recruited from three tertiary centers. Serum markers measured included total PSA (tPSA), free-to-total PSA (f/tPSA), p2PSA, percentage of p2PSA (%p2PSA), and prostate health index (PHI). The association between serum markers and PCa risk was assessed by logistic regression. Predictive performance for each marker was quantified using the area under the receiver operator curves (AUC). Among 516 men, 18.2% had PCa at biopsy. For all tested markers, their predictive value on PCa risk was lower in obese patients compared to normal weight patients. We found statistically significant interactions between BMI and tPSA (P = 0.0026) and p2PSA (P = 0.038). PHI achieved an AUC of 0.872 in normal weight patients and 0.745 in obese patients, which outperformed the other predictors regardless of BMI category. In conclusion, PHI achieved the best predictive performance for detecting PCa and was not influenced by BMI.

Body mass weighted PSA levels, new markers to predict locally advanced prostate cancer after prostatectomy

“…For all tested markers, the predictive value of cancer risk was lower in obese patients than in normal-weight patients. 11 In our study, there was no remarkable correlation between PSA concentration and BW/BMI (Supplementary Table 3, http://links.lww.com/JCMA/ A258).…”

“…Also, compared to normal-weight men, the PSA concentration of overweight men was 3.43% lower, and obese men were 12.9% lower. 10 A study conducted by Zhu et al 11 revealed 516 men, of whom 18.2% had PCA at biopsy. For all tested markers, the predictive value of cancer risk was lower in obese patients than in normal-weight patients.…”

Diagnostic performance of PCA3 and hK2 in combination with serum PSA for prostate cancer

“…However, PSA is a prostate-specific but not a Pca -specific marker. [ 5 ] The human body can synthesize PSA not only confined to the Pca tissue, but also including normal prostate tissue, many studies have pointed out that all disease destroy prostate epithelial cells can cause elevated PSA in the blood, but PSA rise more apparent in patients with Pca, which leads to PSA as markers for diagnosis of Pca has a high misdiagnosis rate, especially in the PSA ”grey area” (4–10 ng/mL) patients. When PSA is 4 to 10 ng/mL, specificity rate is only 48.6%, with 50% of the rate of misdiagnosis.…”

Unfoldomics of prostate cancer: on the abundance and roles of intrinsically disordered proteins in prostate cancer

“…The need for the constant improvement of the diagnostics tools is given, for example, by a recently established effect of obesity (measured in terms of the body mass index) on the predictive performance of the well-established and widely used biomarker, prostate-specific antigen (PSA), and PSA-related markers for prostate cancer. 2 These and similar facts alone should be sufficient to spark the scientific community's interest in studying more on possible causes of this very common male disease. Sometimes, a new approach needs to be taken to further the advancements in biomedical research.…”

“…Although there has been progress in the detection and treatment of prostate cancer, it is clear that more research is needed to make the diagnosis more reliable. The need for the constant improvement of the diagnostics tools is given, for example, by a recently established effect of obesity (measured in terms of the body mass index) on the predictive performance of the well-established and widely used biomarker, prostate-specific antigen (PSA), and PSA-related markers for prostate cancer 2. These and similar facts alone should be sufficient to spark the scientific community's interest in studying more on possible causes of this very common male disease.…”