fPSA
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Prostate cancer is the most common tumor in the male population in Western Europe and USA. In the Czech Republic incidence is 96.87/100 000 inhabitants (NOR 2005). Prostate cancer is third most frequent causation of death for malignant tumor (28.52/1000 inhabitants). The main diagnostic marker for evidence of prostate cancer is prostate-specific antigen (PSA). In the blood portion of PSA is bound with proteins and the rest is free (free PSA). PSA Author email: is organ-specific but not cancer-specific, and serum levels may be elevated in the presence of benign prostatic hypertrophy, prostatitis and other non-malignant conditions. Low specificity of PSA is the reason for developing of new practices. The aim was to find out efficiency of free to total PSA ratio (fPSA/tPSA) pro diagnostic of the prostate cancer. Material and methods: Since 6/2006 to 2/2008 we provided 543 prostate biopsies on Department of Urology, Teaching Hospital Olomouc. We evaluated 418 cases with free to total PSA ratio. Results: Prostate cancer was proved in 90 patients, the average fPSA/tPSA was 12.9%. In 328 biopsies with non-malignant conditions average fPSA/tPSA was 17.46%. In 209 patients with BPH was average fPSA/tPSA 18.25%, in 59 patients with inflammation was 15.216%. In 37 patients with prostatic dysplasia average fPSA/tPSA was 18.31%. These data were evaluated with Wilcoxon rank sum test. We find out significant differences between prostate cancer and all other conditions (p<0.0001). We did not prove significant differences between cancer grades (Gleason score). Conclusions: Usage of free to total PSA ratio in prostate cancer diagnostic can decrease number of unnecessary prostate biopsies and preserve high detection rate of prostate cancer.
BACKGROUND: To compare the clinical performance of a new PCa serum biomarker based on fPSA glycoprofiling to fPSA% and PHI. METHODS: Serum samples from men who underwent prostate biopsy due to increased PSA were used. A comparison between two equal groups (with histologically confirmed PCa or benign, non-cancer condition) was used for the clinical validation of a new glycan-based PCa oncomarker. SPSS and R software packages were used for the multiparametric analyses of the receiver operating curve (ROC) and for genetic algorithm metaheuristics. RESULTS: When comparing the non-cancer and PCa cohorts, the combination of four fPSA glycoforms with two clinical parameters (PGI, prostate glycan index (PGI)) showed an area under receiver operating curve (AUC) value of 0.821 (95% CI 0.754-0.890). AUC values were 0.517 for PSA, 0.683 for fPSA%, and 0.737 for PHI. A glycan analysis was also applied to discriminate low-grade tumors (GS = 6) from significant tumors (GS ≥ 7). CONCLUSIONS: Compared to PSA on its own, or fPSA% and the PHI, PGI showed improved discrimination between presence and absence of PCa and in predicting clinically significant PCa. In addition, the use of PGI would help practitioners avoid 63.5% of unnecessary biopsies, while the use of fPSA% and PHI would help avoid 17.5% and 33.3% of biopsies, respectively, while missing four significant tumors (9.5%).
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Prostate cancer is a common cancer in men. Detection methods include the measurement of biomarkers: prostate-specific antigen (PSA), free PSA, [-2]proPSA, and the calculated indices: fPSA/tPSA ratio and Prostate Health Index (PHI). Proper preanalytical conditions are crucial for precise measurement and failure to adhere to protocols or regulations can influence the diagnostic algorithm. We assessed the stability of the above-mentioned biomarkers, fPSA/tPSA ratio and PHI, under various pre-analytical conditions. METHODS: Serum samples from 45 males were collected and stored under specific conditions before tPSA, fPSA, and [-2]proPSA were measured. Subsequently, the fPSA/tPSA and PHI were calculated. RESULTS: tPSA, fPSA, and [-2]proPSA remained stable during the two freeze-thaw cycles. Storage at 4°C and 22°C resulted in stable tPSA concentrations. However, fPSA levels decreased and [-2]proPSA levels increased over time. The fPSA/tPSA ratio remained stable for 72 h, at which point a decrease was observed in the samples kept at 4°C and 22°C. A gradual increase in PHI was observed in the samples kept at 4°C and 22°C. CONCLUSIONS: All biomarkers remained stable during two freeze-thaw cycles. tPSA was the most stable analyte when stored at 4°C, as well as at RT. A gradual increase of [-2]proPSA and a slight decrease in fPSA were observed during the storage test. This led to a decrease in the fPSA/tPSA ratio and an elevation in the PHI. We therefore recommend measuring prostate biomarkers promptly following blood collection. IMPACT: Understanding the pre-analytical stability of prostate biomarkers helps prevent false positive results and improve the accuracy of diagnostics for prostate cancer.
- MeSH
- lidé MeSH
- nádory prostaty * diagnóza MeSH
- prostata patologie MeSH
- prostatický specifický antigen * krev chemie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The medication used to treat benign prostate hyperplasia (BPH), a common condition in men over 50 years of age, can alter the levels of biomarkers used in prostate cancer detection. Commonly used medications for BPH include alpha-blockers, 5-alpha reductase inhibitors (5-ARIs), and muscarinic antagonists. We studied the impact of these drugs on total prostate-specific antigen (tPSA), free PSA (fPSA), [-2]proPSA, fPSA/tPSA ratio, and the Prostate Health Index (PHI), as well as novel potential biomarkers in the form of glycan composition of fPSA. PATIENTS AND METHODS: Serum samples were collected from 564 males with BPH, with a mean age of 68.5 years. The samples were used to measure levels of tPSA, fPSA, and [-2]proPSA. The fPSA/tPSA and PHI were then calculated. The glycan composition of fPSA was analyzed using lectin-based glycoprofiling. Pharmacotherapy data was collected from the patients' medical records. RESULTS: Alpha-blocker monotherapy was associated with higher fPSA and fPSA/tPSA ratio, and decreased PHI. Levels of tPSA were not impacted. Alpha-blocker and 5-ARI dual therapy was associated with reduced levels of fPSA, [-2]proPSA, and PHI. Therapy combining alpha-blockers and antimuscarinic agents did not significantly influence biomarker levels apart from an increase in a Maackia amurensis lectin-recognized glycan originating in fPSA. CONCLUSION: BPH pharmacotherapy notably affects prostate cancer biomarkers. Recognizing the impact of pharmacotherapy is crucial for achieving an accurate diagnosis of prostate cancer and for planning treatment.
- MeSH
- alfa blokátory terapeutické užití MeSH
- antagonisté muskarinových receptorů * terapeutické užití MeSH
- glykosylace MeSH
- hyperplazie prostaty * krev farmakoterapie MeSH
- inhibitory 5-alfa-reduktasy terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory prostaty krev farmakoterapie MeSH
- prostata patologie metabolismus MeSH
- prostatický specifický antigen * krev MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
Autoři doporučují při screeningu prostatických onemocnění využít hodnot PSA a volného PSA.
The authors recommend in prostatic diseases screening to employ the values of PSA and free PSA.
