Title: PD53-07 CLINICAL SIGNIFICANCE OF THE SIAα2,3GAL-GLYCOSYLATED PROSTATE-SPECIFIC ANTIGEN ASSAY FOR PROSTATE CANCER DETECTION
Abstract: INTRODUCTION AND OBJECTIVE: To reduce unnecessary prostate biopsies (Pbx), better discrimination is needed. To identify significant prostate cancer (sigPC) we determined the performance of Siaα2,3Gal-glycosylated prostate-specific antigen (S2,3PSA) and S2,3PSA normalized by prostate volume (S2,3PSAD). METHODS: We retrospectively measured S2,3PSA, total PSA (tPSA), and free PSA/tPSA (F/T PSA) values in 349 men who underwent a Pbx in three academic urology clinics in Japan and Canada (Pbx cohort). The assays were evaluated using the area under receiver operating characteristics curve (AUC) and decision curve analyses (DCA) to discriminate overall PC and sigPC. RESULTS: In the Pbx cohort, S2,3PSAD (AUC 0.795) provided significantly better clinical performance for discriminating overall PC compared with S2,3PSA (AUC 0.780, p <0.0001), PSAD (AUC 0.684, p <0.0001), tPSA (AUC 0.552, p <0.0001) and F/T PSA (AUC 0.689, p <0.0001). DCA analysis showed that using a risk threshold of 30%, adding S2,3PSA and S2,3PSAD to the base model (age, DRE status, tPSA, and F/T PSA) permitted avoidance of even more biopsies without missing PC (8.0% and 7.6% resp. vs. -0.3% (base model)). In addition, S2,3PSAD (AUC 0.827) provided significantly better clinical performance for discriminating sigPC compared with S2,3PSA (AUC 0.778, p <0.0001), PSAD (AUC 0.787, p <0.0001), tPSA (AUC 0.642,p <0.0001) and F/T PSA (AUC 0.686, p <0.0001). DCA analysis showed that using a risk threshold of 30%, adding S2,3PSA and S2,3PSAD to the base model permitted avoidance of even more biopsies without missing sigPC (14.0% and 13.2% resp. vs. 2.3% (base model)). CONCLUSIONS: The diagnostic performance of S2,3PSA is significantly better than the PSA, FT/ PSA & PSAD test in identifying patients with overall PC and sigPC. Addition of S2,3PSA test to conventional diagnostic model significantly improve avoidable biopsy effect in identifying patients with PC.Source of Funding: none
Publication Year: 2020
Publication Date: 2020-04-01
Language: en
Type: article
Indexed In: ['crossref']
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