[−2]proPSA versus ultrasensitive PSA fluctuations over time in the first year from radical prostatectomy, in an high-risk prostate cancer population: A first report

BMC Urology

Research Article

A. Sottile¹  R. Passera²  C. Fiori³  S. De Luca³  F. Porpiglia³  R. M. Scarpa³ 

[1] Division of Laboratory Medicine, Candiolo Cancer Institute, Candiolo, Italy;Division of Nuclear Medicine, San Giovanni Battista Hospital and University of Torino, Corso AM Dogliotti 14, 10126, Torino, Italy;Division of Urology, San Luigi Gonzaga Hospital and University of Torino, Orbassano, Italy;

关键词: Prostate cancer;    (−2)pro-prostate-specific antigen;    Prostate-specific antigen;    Biochemical recurrence;   

DOI  :  10.1186/s12894-016-0131-0

 received in 2015-11-04, accepted in 2016-03-16,  发布年份 2016

来源: Springer

【 摘 要 】

Background[−2]proPSA and its derivatives have an higher diagnostic accuracy than PSA in predicting prostate cancer (PCa). In alternative to PSA, ultrasensitive PSA (uPSA) and [−2]proPSA could be potentially useful in recurrent disease detection. This research focused on [−2]proPSA and uPSA fluctuations over time and their possible clinical and pathological determinants, in the first year after RP.MethodsA cohort of 106 consecutive patients, undergoing RP for high-risk prostate cancer (pT3/pT4 and/or positive margins), was enrolled. No patient received either preoperative/postoperative androgen deprivation therapy or immediate adjuvant RT, this latter for patient choice. [−2]proPSA and uPSA were measured at 1, 3, 6, 9, 12 months after RP; their trends over time were estimated by the mixed-effects linear model. The uPSA relapse was defined either as 3 rising uPSA values after nadir or 2 consecutive uPSA >0.2 ng/ml after RP.ResultsThe biochemical recurrence (BCR) rate at 1 year after RP was either 38.6 % (in case of 3 rising uPSA values) or 34.9 % (in case of PSA >0.2 ng/ml after nadir), respectively. The main risk factors for uPSA fluctuations over time were PSA at diagnosis >8 ng/ml (p = 0.014), pT (p = 0.038) and pN staging (p = 0.001). In turn, PSA at diagnosis >8 ng/ml (p = 0.012) and pN (p < 0.001) were the main determinants for [−2]proPSA trend over time. In a 39 patients subgroup, uPSA decreased from month 1 to 3, while [−2]proPSA increased in 90 % of them; subsequently, both uPSA and [−2]proPSA increased in almost all cases. The [−2]proPSA trend over time was independent from BCR status either in the whole cohort as well in the 39 men subgroup.ConclusionsBoth uPSA and [−2]proPSA had independent significant fluctuations over time. PSA at diagnosis >8 ng/ml and pathological staging significantly modified both these trends over time. Since BCR was not confirmed as determinant of [−2]proPSA fluctuations, its use as marker of early biochemical relapse may not be actually recommended, in an high-risk prostate cancer patients population.

【 授权许可】

CC BY   
© De Luca et al. 2016