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

Carlsson, Sigrid V. ; Peltola, Mari T. ; Sjoberg, Daniel ; Schroder, Fritz H. ; Hugosson, Jonas ; Pettersson, Kim ; Scardino, Peter T. ; Vickers, Andrew J. ; Lilja, Hans LU and Roobol, Monique J. (2013) In BJU International 112(5). p.602-609
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 Gteborg (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... (More)
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 Gteborg (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 Gteborg. 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 Gteborg). 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. (Less)
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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
prostate cancer, transrectal ultrasonography, kallikreins, prostate-specific antigen
in
BJU International
volume
112
issue
5
pages
602 - 609
publisher
Blackwell Science Ltd
external identifiers
  • wos:000322819200015
  • scopus:84882282960
  • pmid:23448270
ISSN
1464-4096
DOI
10.1111/j.1464-410X.2012.11690.x
language
English
LU publication?
yes
id
1256058e-5e15-4ae0-9b67-56d9a6054e77 (old id 4027127)
date added to LUP
2016-04-01 10:40:31
date last changed
2020-09-02 01:19:08
@article{1256058e-5e15-4ae0-9b67-56d9a6054e77,
  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 Gteborg (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 Gteborg. 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 Gteborg). 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.},
  author       = {Carlsson, Sigrid V. and Peltola, Mari T. and Sjoberg, Daniel and Schroder, Fritz H. and Hugosson, Jonas and Pettersson, Kim and Scardino, Peter T. and Vickers, Andrew J. and Lilja, Hans and Roobol, Monique J.},
  issn         = {1464-4096},
  language     = {eng},
  number       = {5},
  pages        = {602--609},
  publisher    = {Blackwell Science Ltd},
  series       = {BJU International},
  title        = {Can one blood draw replace transrectal ultrasonography-estimated prostate volume to predict prostate cancer risk?},
  url          = {http://dx.doi.org/10.1111/j.1464-410X.2012.11690.x},
  doi          = {10.1111/j.1464-410X.2012.11690.x},
  volume       = {112},
  year         = {2013},
}