Clinical performance of serum prostate‐specific antigen isoform [‐2]proPSA (p2PSA) and its derivatives, %p2PSA and the prostate health index (PHI), in men with a family history of prostate cancer: results from a multicentre European study, the PROMEtheuS project

Abstract

Objectives• To test the sensitivity, specificity and accuracy of serum prostate-specific antigen isoform [-2]proPSA (p2PSA), %p2PSA and the prostate health index (PHI), in men with a family history of prostate cancer (PCa) undergoing prostate biopsy for suspected PCa.• To evaluate the potential reduction in unnecessary biopsies and the characteristics of potentially missed cases of PCa that would result from using serum p2PSA, %p2PSA and PHI. Patients and Methods• The analysis consisted of a nested case-control study from the PRO-PSA Multicentric European Study, the PROMEtheuS project.• All patients had a first-degree relative (father, brother, son) with PCa.• Multivariable logistic regression models were complemented by predictive accuracy analysis and decision-curve analysis. Gleason score (r: 0.247, P = 0.038; r: 0.366, P = 0.002; r: 0.464, P < 0.001, respectively). Results • Of the 1026 patients included in the PROMEtheuS Conclusions• %p2PSA and PHI are more accurate than tPSA, fPSA and %fPSA in predicting PCa in men with a family history of PCa.• Consideration of %p2PSA and PHI results in the avoidance of several unnecessary biopsies. • p2PSA, %p2PSA and PHI correlate with cancer aggressiveness.

The percentage of prostate‐specific antigen (PSA) isoform [–2]proPSA and the Prostate Health Index improve the diagnostic accuracy for clinically relevant prostate cancer at initial and repeat biopsy compared with total PSA and percentage free PSA in men aged ≤65 years

“…Within this range, more unnecessary biopsies can be spared compared with standard testing. These results have recently been supported by the DCA on a large ageindependent cohort with initial biopsies by Lazzeri et al [39] and Ferro et al [40].…”

Serum prostate-specific antigen as a predictor of prostate volume in Sudanese patients with benign prostatic hyperplasia

“…Previous studies have focused on the relationship between serum PSA and PV (Choi et According to these studies on serum PSA, there were strong relationship with PV, and they found that PSA would be able to predict the PV. Other studies on free PSA showed a loglinear relationship with PV and free PSA predicted PV more precisely than total PSA in BPH patients (Canto et al 2004, Lazzeri et al 2013). The ability of PSA to predict PV increased with prostate size.…”

Time to replace prostate‐specific antigen (PSA) with the Prostate Health Index (PHI)? Yet more evidence that the PHI consistently outperforms PSA across diverse populations

“…The investigators from the PROMEtheus multicentre European trial have previously validated the use of the PHI in men with a positive family history of prostate cancer [4] Among the 965 participants in the PROMEtheus study, 14.7% were considered obese based on a body mass index ≥30 kg/m 2 . In this group, 45.8% were diagnosed with prostate cancer from a ≥12-core biopsy, and 67.7% had a Gleason score ≥7.…”