Improving the Specificity of PSA Screening with Serum and Urine Markers

Kearns, James T.; Lin, Daniel W.

doi:10.1007/s11934-018-0828-6

Cited by 27 publications

(24 citation statements)

References 24 publications

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“…Hence, the accurate classification of PCa using the 10-biomarker panel in a cohort comprising other urological cancers is an important achievement. Notably, the 10-biomarker panel outperforms not only PSA [5][6][7], but also PCA3 [9] and PHI [10] in differentiating PCa patients from controls.…”

Section: Discussionmentioning

confidence: 96%

“…However, these procedures have serious limitations and have led to overdiagnosis and consequent overtreatment of low-risk patients, unnecessary biopsies, and unwarranted radical prostatectomies [4]. Indeed, the standard serum PSA cut-off of 4 ng/mL has failed to meet the criteria required for an effective biomarker due to its limited sensitivity (20.5%), specificity (51-91%) [5,6], area under the curve (AUC) (0.53-0.83), and accuracy (62-75%) [7]. Based on these limitations, several research groups have proposed new candidate biomarkers for PCa detection (e.g., prostate cancer antigen 3 (PCA3) and prostate health index (PHI)) [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

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A Panel of Urinary Volatile Biomarkers for Differential Diagnosis of Prostate Cancer from Other Urological Cancers

Lima

Pinto

Carvalho‐Maia

et al. 2020

Cancers

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Our group recently developed a urinary 6-biomarker panel for the diagnosis of prostate cancer (PCa) which has a higher level of accuracy compared to the serum prostate specific antigen (PSA) test. Herein, urine from an independent cohort of PCa patients and cancer-free controls was analyzed to further validate the discriminative power of that panel. Additionally, urine from patients diagnosed with bladder cancer (BC) and renal cancer (RC) were included to evaluate the site-specificity of the panel. Results confirmed the ability of the 6-biomarker panel to discriminate PCa patients from controls, but not from other urological cancers. To overcome this limitation, an untargeted approach was performed to unveil discriminant metabolites among the three cancer types. A 10-biomarker panel comprising the original panel plus four new metabolites was established to discriminate PCa from controls, BC, and RC, with 76% sensitivity, 90% specificity, and 92% accuracy. This improved panel also disclosed better accuracy than serum PSA test and provides the basis for a new non-invasive early detection tool for PCa.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

A Panel of Urinary Volatile Biomarkers for Differential Diagnosis of Prostate Cancer from Other Urological Cancers

Lima

Pinto

Carvalho‐Maia

et al. 2020

Cancers

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“…In addition, there have been recent reports of problems with overdiagnosis of nonsignificant cancer and its overtreatment. 15 …”

Section: Discussionmentioning

confidence: 99%

Strategy for Prostate Cancer Patients with Low Prostate Specific Antigen Level (2.5 to 4.0 ng/mL)

Chung

Song

et al. 2020

J Korean Med Sci

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Background To evaluate the strategy for detection of prostate cancer (PCa) with low prostate specific antigen (PSA) level (2.5–4.0 ng/mL), prostate biopsy patients with low PSA were assessed. We evaluated the risk of low PSA PCa and the strategy for screening low-PSA patients. Methods We retrospectively analyzed the patients who underwent prostate biopsy with low PSA level. Baseline characteristics, PSA level before prostate biopsy, prostate volume, prostate specific antigen density (PSAD), and pathological data were assessed. Results Among the 1986 patients, 24.97% were diagnosed with PCa. The PSAD was 0.12 ± 0.04 ng/mL 2 in the PCa-diagnosed group and 0.10 ± 0.04 ng/mL 2 in non-cancer-diagnosed group ( P < 0.001). Of the 496 patients diagnosed with PCa, 302 (60.89%) were in the intermediate- or high-risk group. PSAD was 0.13 ± 0.04 ng/mL 2 in the intermediate- or high-risk group and 0.11 ± 0.03 ng/mL 2 in the very low- and low-risk group ( P < 0.001). Of 330 patients who underwent radical prostatectomy, 85.15% were diagnosed as having significant cancer. There was significant correlation between PSAD and PCa ( r = 0.294, P < 0.001). PSAD with a specificity of 80.00% of a clinically significant cancer diagnosis was assessed at 0.1226 ng/mL 2 . Conclusion The PCa detection rate in the low-PSA group was not lower than that of previous studies of patients with PSA from 4.0 to 10.0 ng/mL. Further, it may be helpful to define a strategy for PCa detection using PSAD in the low-PSA group.

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“…Recent advances in genomic sequencing and molecular classification led to development of a plethora of assays for PCa diagnosis; therefore, considerable effort has been given to identify novel tissue, serum, and urine-based biomarkers to better stratify at-risk patients (20,21). For the diagnosis of PCa, biomarkers should ideally be detectable in body fluids that can be obtained non-invasively and therefore urine has emerged as the substrate for the non-invasive detection of PCa.…”

Section: Discussionmentioning

confidence: 99%

Multiparametric MRI Versus SelectMDx Accuracy in the Diagnosis of Clinically Significant PCa in Men Enrolled in Active Surveillance

Pepe

Dibenedetto

Pepe

et al. 2019

In Vivo

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Background/Aim: To evaluate the diagnostic accuracy of the urinary SelectMDx test in the diagnosis of clinically significant prostate cancer (csPCa) in men enrolled in an active surveillance (AS) protocol. Patients and Methods: From July 2015 to July 2018, 125 men with very low-risk PCa were enrolled in the AS protocol; all patients underwent confirmatory transperineal saturation biopsy (SPBx). In the presence of PI-RADS score ≥3, a targeted MRI/TRUS fusion-guided biopsy was added to SPBx. Postdigital rectal examination urine was collected in 45/125 (36%) patients before SPBx; the genetic urine analysis was performed using a biomarker-based risk score model, the SelectMDx, that measured mRNA levels of distal-less homeobox 1 (DLX1) and homeobox C6 (HOXC6). Results: A total of 9/45 (20%) patients were reclassified as csPCa (7 cases=Grade Group 2; 2 cases=Grade Group 3); sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of mpMRI vs. SelectMDx in the diagnosis of csPCa were equal to 66.

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Improving the Specificity of PSA Screening with Serum and Urine Markers

Cited by 27 publications

References 24 publications

A Panel of Urinary Volatile Biomarkers for Differential Diagnosis of Prostate Cancer from Other Urological Cancers

A Panel of Urinary Volatile Biomarkers for Differential Diagnosis of Prostate Cancer from Other Urological Cancers

Strategy for Prostate Cancer Patients with Low Prostate Specific Antigen Level (2.5 to 4.0 ng/mL)

Multiparametric MRI Versus SelectMDx Accuracy in the Diagnosis of Clinically Significant PCa in Men Enrolled in Active Surveillance

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