Utility of Prostate-Specific Antigen Isoforms and Prostate Health Index in the Diagnosis of Metastatic Prostate Cancer

Abstract

Objective The current study was undertaken to investigate the utility of total prostate-specific antigen (tPSA), its isoform [-2] proPSA (p2PSA), and prostate health index (PHI) in the diagnosis of metastatic prostate cancer (PCa). Materials and Methods This study was conducted from March 2016 to May 2019. Eighty-five subjects who were diagnosed with PCa for the first time, following transrectal ultrasound-guided prostate biopsy, were included in the study. The prebiopsy blood samples were analyzed in Beckman Coulter Access-2 Immunoanalyzer for tPSA, p2PSA, and free PSA (fPSA), and the calculated parameters included %p2PSA, %fPSA, and PHI. Mann–Whitney's U test was used as test of significance, and p-value less than 0.05 was considered statistically significant. Results Of the 85 participants, 81.2% (n = 69) had evidence of metastasis, both clinically and pathologically. The median tPSA (ng/mL), p2PSA (pg/mL), %p2PSA, and PHI were significantly higher in the group with evidence of metastasis (46.5 vs. 13.76; 198.0 vs. 35.72; 3.25 vs. 1.51; 237.58 vs. 59.74, respectively). The sensitivity (%), specificity (%), negative predictive value (%), and positive predictive value (%) to diagnose metastatic PCa of tPSA at a cutoff of 20 ng/mL, PHI at a cutoff of 55, and %p2PSA at a cutoff of 1.66 were 92.7, 98.5, and 94.2; 37.5, 43.7, and 62.5; 54.5, 87.5, and 71.4; and 86.4, 88.3, and 91.5, respectively. Conclusion Using tests such as %p2PSA and PHI in the standard armamentarium for the diagnosis of metastatic PCa in addition to PSA will help in selecting the appropriate treatment strategy, including active surveillance.

Second generation androgen receptor antagonist, TQB3720 abrogates prostate cancer growth via AR/GPX4 axis activated ferroptosis

“…Prostate cancer, especially metastatic PCa, poses a great threat to humans worldwide (Raju et al, 2022). Therefore, developing effective and safe anti-cancer agents is critical to prolong the life of patients, reduce death rates, and improve survival.…”

Determinants of Survival and Prognostic Factors in Patients with Prostate Cancer: A Retrospective Analysis (2009-2018)

“…However, sending these data is mandatory for hospitals qualified in specialized oncology care in the SUS and optional for hospitals that are not qualified [2,5], which implies limitations in PC screening by RHC and, consequently, controversial results. Furthermore, the approaches used to determine this rate did not consider the patient's age, general health status, response to treatment, and PSA, among other factors that can also affect the patient's prognosis [20,21]. Thus, well-conducted cohort studies are relevant to better characterize the survival of these individuals.…”