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The percentage of −2 pro–prostate-specific antigen and the prostate health index outperform prostate-specific antigen and the percentage of free prostate-specific antigen in the detection of clinically significant prostate cancer and can be used as reflex tests

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dc.contributor.authorGarrido, Manuel Matos
dc.contributor.authorMarta, José C.
dc.contributor.authorBernardino, Rui M.
dc.contributor.authorGuerra, João
dc.contributor.authorFernandes, Francisco
dc.contributor.authorPereira, Maria H.
dc.contributor.authorRibeiro, Ruy
dc.contributor.authorHoldenrieder, Stefan
dc.contributor.authorPinheiro, Luís C.
dc.contributor.authorGuimarães, João T.
dc.date.accessioned2022-06-06T15:45:53Z
dc.date.available2022-06-06T15:45:53Z
dc.date.issued2022
dc.description© 2010 College of American Pathologists. Permission to use figures, tables, and brief excerpts from this work in scientific and educational works is hereby granted provided that the source is acknowledged. Any use of material in this work that is determined to be "fair use" under Section 107 or that satisfies the conditions specified in Section 108 of the U.S. copyright Law (17 USC, as revised by P.L. 94-553) does not require the society's permission. Republication, systematic reproduction, posting in electronic form on servers, or other uses of this material, except as exempted by the above statements, requires written permission or license from College of American Pathologists.pt_PT
dc.description.abstractContext.—: There is a need to avoid the overdiagnosis of prostate cancer (PCa) and to find more specific biomarkers. Objective.—: To evaluate the clinical utility of [-2]pro-prostate-specific antigen ([-2]proPSA) derivatives in detecting clinically significant PCa (csPCa) and to compare it with prostate-specific antigen (PSA) and with the percentage of free PSA (%fPSA). Design.—: Two hundred thirty-seven men (PSA: 2-10 ng/mL) scheduled for a prostate biopsy were enrolled. Parametric and nonparametric tests, receiver operating characteristic curves, and logistic regression analysis were applied. Outcomes were csPCa and overall PCa. Results.—: Both [-2]proPSA derivatives were significantly higher in csPCa and overall PCa (P < .001). The areas under the curves for the prediction of csPCa were higher for the percentage of [-2]proPSA (%[-2]proPSA) (0.781) and the prostate health index (PHI) (0.814) than for PSA (0.651) and %fPSA (0.724). There was a gain of 11% in diagnostic accuracy when %[-2]proPSA or PHI were added to a base model with PSA and %fPSA. Twenty-five percent to 29% of biopsies could have been spared with %[-2]proPSA (cutoff: ≥1.25%) and PHI (cutoff: ≥27), missing 10% of csPCas. The same results could have been achieved by using [-2]proPSA as a reflex test, when %fPSA was 25% or less (cutoffs: ≥1.12% and ≥24 for %[-2]proPSA and PHI, respectively). Conclusions.—: The [-2]proPSA derivatives improve the diagnostic accuracy of csPCa when the PSA value is between 2 and 10 ng/mL, sparing unnecessary biopsies and selecting patients for active surveillance. [-2]proPSA can be used as a reflex test when %fPSA is 25% or less, without reducing the diagnostic accuracy for csPCa and the number of spared biopsies.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationArch Pathol Lab Med. 2022 Jun 1;146(6):691-700pt_PT
dc.identifier.doi10.5858/arpa.2021-0079-OApt_PT
dc.identifier.eissn1543-2165
dc.identifier.issn0003-9985
dc.identifier.urihttp://hdl.handle.net/10451/53297
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherAllen Presspt_PT
dc.relation.publisherversionhttps://meridian.allenpress.com/aplmpt_PT
dc.titleThe percentage of −2 pro–prostate-specific antigen and the prostate health index outperform prostate-specific antigen and the percentage of free prostate-specific antigen in the detection of clinically significant prostate cancer and can be used as reflex testspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage700pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage691pt_PT
oaire.citation.titleArchives of Pathology & Laboratory Medicinept_PT
oaire.citation.volume146pt_PT
person.familyNameGarrido
person.familyNameRibeiro
person.givenNameManuel
person.givenNameRuy Miguel
person.identifier.ciencia-id3917-8EF1-B710
person.identifier.ciencia-id9A15-E40B-738F
person.identifier.orcid0000-0003-0302-4094
person.identifier.orcid0000-0002-3988-8241
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication2c4b0db3-0025-4292-a44e-99ab60a1233a
relation.isAuthorOfPublication215b5cf4-faab-41ea-becf-c63bed56d3d1
relation.isAuthorOfPublication.latestForDiscovery2c4b0db3-0025-4292-a44e-99ab60a1233a

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