Format

Send to:

Choose Destination

See 1 citation found by title matching your search:

See comment in PubMed Commons below
BJU Int. 2013 Sep;112(5):602-9. doi: 10.1111/j.1464-410X.2012.11690.x. Epub 2013 Feb 28.

Can one blood draw replace transrectal ultrasonography-estimated prostate volume to predict prostate cancer risk?

Author information

  • 1Department of Surgery (Urology Service), Memorial Sloan-Kettering Cancer Center, New York, USA; Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg.

Abstract

OBJECTIVE:

To explore whether a panel of kallikrein markers in blood: total, free and intact prostate-specific antigen (PSA) and kallikrein-related peptidase 2, could be used as a non-invasive alternative for predicting prostate cancer on biopsy in a screening setting.

SUBJECTS AND METHODS:

The study cohort comprised previously unscreened men who underwent sextant biopsy owing to elevated PSA (≥3 ng/mL) in two different centres of the European Randomized Study of Screening for Prostate Cancer, Rotterdam (n = 2914) and Göteborg (n = 740). A statistical model, based on kallikrein markers, was compared with one based on established clinical factors for the prediction of biopsy outcome.

RESULTS:

The clinical tests were found to be no better than blood markers, with an area under the curve in favour of the blood measurements of 0.766 vs. 0.763 in Rotterdam and 0.809 vs. 0.774 in Göteborg. Adding digital rectal examination (DRE) or DRE plus transrectal ultrasonography (TRUS) volume to the markers improved discrimination, although the increases were small. Results were similar for predicting high-grade cancer. There was a strong correlation between the blood measurements and TRUS-estimated prostate volume (Spearman's correlation 0.60 in Rotterdam and 0.57 in Göteborg).

CONCLUSIONS:

In previously unscreened men, each with indication for biopsy, a statistical model based on kallikrein levels was similar to a clinical model in predicting prostate cancer in a screening setting, outside the day-to-day clinical practice. Whether a clinical approach can be replaced by laboratory analyses or used in combination with decision models (nomograms) is a clinical judgment that may vary from clinician to clinician depending on how they weigh the different advantages and disadvantages (harms, costs, time, invasiveness) of both approaches.

© 2013 BJU International.

KEYWORDS:

kallikreins; prostate cancer; prostate-specific antigen; transrectal ultrasonography

PMID:
23448270
[PubMed - indexed for MEDLINE]
PMCID:
PMC3675187
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Blackwell Publishing Icon for PubMed Central
    Loading ...
    Write to the Help Desk