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Prospective validation of microseminoprotein-β added to the 4Kscore in predicting high-grade prostate cancer in an international multicentre cohort

Lonergan, Peter E. ; Vertosick, Emily A. ; Assel, Melissa ; Sjoberg, Daniel D. ; Haese, Alexander ; Graefen, Markus ; Boorjian, Stephen A. ; Klee, George G. ; Cooperberg, Matthew R. and Pettersson, Kim , et al. (2021) In BJU International 128(2). p.218-224
Abstract

Objectives: To prospectively evaluate the performance of a pre-specified statistical model based on four kallikrein markers in blood (total prostate-specific antigen [PSA], free PSA, intact PSA, and human kallikrein-related peptidase 2), commercially available as the 4Kscore, in predicting Gleason Grade Group (GG) ≥2 prostate cancer at biopsy in an international multicentre study at three academic medical centres, and whether microseminoprotein-β (MSP) adds predictive value. Patients and Methods: A total of 984 men were prospectively enrolled at three academic centres. The primary outcome was GG ≥2 on prostate biopsy. Three pre-specified statistical models were used: a base model including PSA, age, digital rectal examination and prior... (More)

Objectives: To prospectively evaluate the performance of a pre-specified statistical model based on four kallikrein markers in blood (total prostate-specific antigen [PSA], free PSA, intact PSA, and human kallikrein-related peptidase 2), commercially available as the 4Kscore, in predicting Gleason Grade Group (GG) ≥2 prostate cancer at biopsy in an international multicentre study at three academic medical centres, and whether microseminoprotein-β (MSP) adds predictive value. Patients and Methods: A total of 984 men were prospectively enrolled at three academic centres. The primary outcome was GG ≥2 on prostate biopsy. Three pre-specified statistical models were used: a base model including PSA, age, digital rectal examination and prior negative biopsy; a model that added free PSA to the base model; and the 4Kscore. Results: A total of 947 men were included in the final analysis and 273 (29%) had GG ≥2 on prostate biopsy. The base model area under the receiver operating characteristic curve of 0.775 increased to 0.802 with the addition of free PSA, and to 0.824 for the 4Kscore. Adding MSP to the 4Kscore model yielded an increase (0.014–0.019) in discrimination. In decision-curve analysis of clinical utility, the 4Kscore showed a benefit starting at a 7.5% threshold. Conclusion: A prospective multicentre evaluation of a pre-specified model based on four kallikrein markers (4Kscore) with the addition of MSP improves the predictive discrimination for GG ≥2 prostate cancer on biopsy and could be used to inform biopsy decision-making.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
#PCSM, #ProstateCancer, #uroonc, 4Kscore, kallikreins, microseminoprotein-β, prostate biopsy, Prostate-specific antigen
in
BJU International
volume
128
issue
2
pages
7 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:85098172819
  • pmid:33306251
ISSN
1464-4096
DOI
10.1111/bju.15320
language
English
LU publication?
yes
id
64a556ff-6f88-4942-8c88-f6fd34ba50fd
date added to LUP
2021-01-12 07:42:37
date last changed
2022-12-01 05:31:55
@article{64a556ff-6f88-4942-8c88-f6fd34ba50fd,
  abstract     = {{<p>Objectives: To prospectively evaluate the performance of a pre-specified statistical model based on four kallikrein markers in blood (total prostate-specific antigen [PSA], free PSA, intact PSA, and human kallikrein-related peptidase 2), commercially available as the 4Kscore, in predicting Gleason Grade Group (GG) ≥2 prostate cancer at biopsy in an international multicentre study at three academic medical centres, and whether microseminoprotein-β (MSP) adds predictive value. Patients and Methods: A total of 984 men were prospectively enrolled at three academic centres. The primary outcome was GG ≥2 on prostate biopsy. Three pre-specified statistical models were used: a base model including PSA, age, digital rectal examination and prior negative biopsy; a model that added free PSA to the base model; and the 4Kscore. Results: A total of 947 men were included in the final analysis and 273 (29%) had GG ≥2 on prostate biopsy. The base model area under the receiver operating characteristic curve of 0.775 increased to 0.802 with the addition of free PSA, and to 0.824 for the 4Kscore. Adding MSP to the 4Kscore model yielded an increase (0.014–0.019) in discrimination. In decision-curve analysis of clinical utility, the 4Kscore showed a benefit starting at a 7.5% threshold. Conclusion: A prospective multicentre evaluation of a pre-specified model based on four kallikrein markers (4Kscore) with the addition of MSP improves the predictive discrimination for GG ≥2 prostate cancer on biopsy and could be used to inform biopsy decision-making.</p>}},
  author       = {{Lonergan, Peter E. and Vertosick, Emily A. and Assel, Melissa and Sjoberg, Daniel D. and Haese, Alexander and Graefen, Markus and Boorjian, Stephen A. and Klee, George G. and Cooperberg, Matthew R. and Pettersson, Kim and Routila, Erica and Vickers, Andrew J. and Lilja, Hans}},
  issn         = {{1464-4096}},
  keywords     = {{#PCSM; #ProstateCancer; #uroonc; 4Kscore; kallikreins; microseminoprotein-β; prostate biopsy; Prostate-specific antigen}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{2}},
  pages        = {{218--224}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{BJU International}},
  title        = {{Prospective validation of microseminoprotein-β added to the 4Kscore in predicting high-grade prostate cancer in an international multicentre cohort}},
  url          = {{http://dx.doi.org/10.1111/bju.15320}},
  doi          = {{10.1111/bju.15320}},
  volume       = {{128}},
  year         = {{2021}},
}