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859 Parallel measurement of urinary PCA3 and TMPRSS2:ERG with serum [−2]proPSA based Phi for prostate cancer detection
859
Parallel measurement of urinary PCA3 and TMPRSS2:ERG with serum [2]proPSA based Phi for prostate cancer detection Eur Urol Suppl 2013;12;e859
Stephan C.1, Semjonow A.2, Schulze-Forster K.3, Cammann H.4, Hu X.1, Miller K.1, Jung K.1, Friedersdorff F.1 1
Charité - Universitätsmedizin Berlin, Dept. of Urology, Berlin, Germany, 2Prostate Center, University Clinic, Dept. of
Urology, Münster, Germany, 3Zentrum Für Molekulare Onkologie, GmbH, Luckenwalde, Germany, 4Charité Universitätsmedizin Berlin, Dept. of Medical Informatics, Berlin, Germany INTRODUCTION & OBJECTIVES: PSA and percent free PSA (%fPSA) show only low specificities in prostate cancer (PCa) detection. We first compared the three new promising markers urinary prostate cancer antigen 3 (PCA3), urinary TMPRSS2:ERG gene fusion (T2:ERG) and serum [-2]pro-PSA (p2PSA)-based prostate health index (Phi) for predicting biopsy outcome. MATERIAL & METHODS: Serum samples and first-catch urine samples (after digital rectal examination, DRE) were collected from consented outpatients with PSA 0.5–20 μg/L scheduled for prostate biopsy. The PCA3 Score (PROGENSA PCA3 Assay, Hologic Gen-Probe) and T2:ERG Score (Hologic Gen-Probe research assay) were determined. Measurements of serum prostate-specific antigen (PSA), free PSA, p2PSA (Beckman Coulter) were performed and %fPSA and Phi (p2PSA/fPSA x √PSA) determined. RESULTS: Of 246 enrolled men 110 (45%) were diagnosed with PCa and 136 men had no evidence of malignancy (NEM). 136 (55%) of all men (70 PCa and 66 NEM) underwent a first set of biopsies and 110 (45%) had at least a repeat one. PCA3, Phi and T2:ERG differed significantly between PCa and NEM and these markers showed the largest AUC of all parameters (0.74, 0.68 and 0.63), respectively. PCA3 had the largest AUC of all parameters although not statistically different from Phi. Phi showed somewhat lower specificities than PCA3 at 90% sensitivity. The combination of both markers enhanced the diagnostic power with modest AUC gains of 0.01 to 0.04. While PCA3 showed the largest advantage in the repeat biopsy cohort, the largest AUC of Phi was observed within the 2-10 μg/L PSA range for DRE negative patients. CONCLUSIONS: PCA3 and Phi were superior to the other evaluated parameters but the combination gave only moderate enhancements in diagnostic accuracy to predict PCa at first or repeat prostate biopsy.
Parallel measurement of urinary PCA3 and TMPRSS2:ERG with serum [2]proPSA based Phi for prostate cancer detection Eur Urol Suppl 2013;12;e859
Stephan C.1, Semjonow A.2, Schulze-Forster K.3, Cammann H.4, Hu X.1, Miller K.1, Jung K.1, Friedersdorff F.1 1
Charité - Universitätsmedizin Berlin, Dept. of Urology, Berlin, Germany, 2Prostate Center, University Clinic, Dept. of
Urology, Münster, Germany, 3Zentrum Für Molekulare Onkologie, GmbH, Luckenwalde, Germany, 4Charité Universitätsmedizin Berlin, Dept. of Medical Informatics, Berlin, Germany INTRODUCTION & OBJECTIVES: PSA and percent free PSA (%fPSA) show only low specificities in prostate cancer (PCa) detection. We first compared the three new promising markers urinary prostate cancer antigen 3 (PCA3), urinary TMPRSS2:ERG gene fusion (T2:ERG) and serum [-2]pro-PSA (p2PSA)-based prostate health index (Phi) for predicting biopsy outcome. MATERIAL & METHODS: Serum samples and first-catch urine samples (after digital rectal examination, DRE) were collected from consented outpatients with PSA 0.5–20 μg/L scheduled for prostate biopsy. The PCA3 Score (PROGENSA PCA3 Assay, Hologic Gen-Probe) and T2:ERG Score (Hologic Gen-Probe research assay) were determined. Measurements of serum prostate-specific antigen (PSA), free PSA, p2PSA (Beckman Coulter) were performed and %fPSA and Phi (p2PSA/fPSA x √PSA) determined. RESULTS: Of 246 enrolled men 110 (45%) were diagnosed with PCa and 136 men had no evidence of malignancy (NEM). 136 (55%) of all men (70 PCa and 66 NEM) underwent a first set of biopsies and 110 (45%) had at least a repeat one. PCA3, Phi and T2:ERG differed significantly between PCa and NEM and these markers showed the largest AUC of all parameters (0.74, 0.68 and 0.63), respectively. PCA3 had the largest AUC of all parameters although not statistically different from Phi. Phi showed somewhat lower specificities than PCA3 at 90% sensitivity. The combination of both markers enhanced the diagnostic power with modest AUC gains of 0.01 to 0.04. While PCA3 showed the largest advantage in the repeat biopsy cohort, the largest AUC of Phi was observed within the 2-10 μg/L PSA range for DRE negative patients. CONCLUSIONS: PCA3 and Phi were superior to the other evaluated parameters but the combination gave only moderate enhancements in diagnostic accuracy to predict PCa at first or repeat prostate biopsy.