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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

Benchikh, Amine ; Savage, Caroline ; Cronin, Angel ; Salama, Gilles ; Villers, Arnauld ; Lilja, Hans LU orcid and Vickers, Andrew (2010) In BMC Cancer 10. p.1-7
Abstract

Background: We 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.Methods: We 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).Results: 83 (32%)... (More)

Background: We 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.Methods: We 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).Results: 83 (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.Conclusions: In 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.

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author
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publishing date
type
Contribution to journal
publication status
published
in
BMC Cancer
volume
10
article number
635
pages
1 - 7
publisher
BioMed Central (BMC)
external identifiers
  • scopus:78549255938
  • pmid:21092177
ISSN
1471-2407
DOI
10.1186/1471-2407-10-635
language
English
LU publication?
no
id
ed9f60f4-690b-449e-86dd-b988a94fc10a
date added to LUP
2022-12-06 15:39:56
date last changed
2024-06-29 01:09:47
@article{ed9f60f4-690b-449e-86dd-b988a94fc10a,
  abstract     = {{<p>Background: We 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.Methods: We 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).Results: 83 (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.Conclusions: In 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.</p>}},
  author       = {{Benchikh, Amine and Savage, Caroline and Cronin, Angel and Salama, Gilles and Villers, Arnauld and Lilja, Hans and Vickers, Andrew}},
  issn         = {{1471-2407}},
  language     = {{eng}},
  month        = {{11}},
  pages        = {{1--7}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Cancer}},
  title        = {{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}},
  url          = {{http://dx.doi.org/10.1186/1471-2407-10-635}},
  doi          = {{10.1186/1471-2407-10-635}},
  volume       = {{10}},
  year         = {{2010}},
}