A panel of kallikrein markers can predict outcome of prostate biopsy following clinical work-up: an independent validation study from the European Randomized Study of Prostate Cancer screening, France

BMC Cancer

Research Article

Gilles Salama¹  Amine Benchikh²  Arnauld Villers³  Angel Cronin⁴  Caroline Savage⁴  Hans Lilja⁴  Andrew Vickers⁴ 

[1] Centre Hospitalier Intercommunal Castres-Mazamet, Castres, France;Hôpital Bichat-Claude Bernard, Paris, France;Hôpital Huriez, CHRU Lille, Lille, France;Memorial Sloan Kettering Cancer Center, New York, NY, USA;

关键词: Prostate Cancer;    Prostate Specific Antigen;    Prostate Biopsy;    Prostate Cancer Screening;    Prostate Specific Antigen Test;   

DOI  :  10.1186/1471-2407-10-635

 received in 2010-06-15, accepted in 2010-11-22,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundWe have previously shown that a panel of kallikrein markers - total prostate-specific antigen (PSA), free PSA, intact PSA and human kallikrein-related peptidase 2 (hK2) - can predict the outcome of prostate biopsy in men with elevated PSA. Here we investigate the properties of our panel in men subject to clinical work-up before biopsy.MethodsWe applied a previously published predictive model based on the kallikrein panel to 262 men undergoing prostate biopsy following an elevated PSA (≥ 3 ng/ml) and further clinical work-up during the European Randomized Study of Prostate Cancer screening, France. The predictive accuracy of the model was compared to a "base" model of PSA, age and digital rectal exam (DRE).Results83 (32%) men had prostate cancer on biopsy of whom 45 (54%) had high grade disease (Gleason score 7 or higher). Our model had significantly higher accuracy than the base model in predicting cancer (area-under-the-curve [AUC] improved from 0.63 to 0.78) or high-grade cancer (AUC increased from 0.77 to 0.87). Using a decision rule to biopsy those with a 20% or higher risk of cancer from the model would reduce the number of biopsies by nearly half. For every 1000 men with elevated PSA and clinical indication for biopsy, the model would recommend against biopsy in 61 men with cancer, the majority (≈80%) of whom would have low stage and low grade disease at diagnosis.ConclusionsIn this independent validation study, the model was highly predictive of prostate cancer in men for whom the decision to biopsy is based on both elevated PSA and clinical work-up. Use of this model would reduce a large number of biopsies while missing few cancers.

【 授权许可】

Unknown   
© Benchikh et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.