title: Serum early prostate cancer antigen (EPCA) level and its association with disease progression in prostate cancer in a Chinese population.
abstract: BACKGROUND
  Early prostate cancer antigen (EPCA) has been shown a prostate cancer (PCa)-associated nuclear matrix protein, however, its serum status and prognostic power in PCa are unknown. The goals of this study are to measure serum EPCA levels in a cohort of patients with PCa prior to the treatment, and to evaluate the clinical value of serum EPCA.
  
  
  METHODS
  Pretreatment serum EPCA levels were determined with an ELISA in 77 patients with clinically localized PCa who underwent radical prostatectomy and 51 patients with locally advanced or metastatic disease who received primary androgen deprivation therapy, and were correlated with clinicopathological variables and disease progression. Serum EPCA levels were also examined in 40 healthy controls.
  
  
  RESULTS
  Pretreatment mean serum EPCA levels were significantly higher in PCa patients than in controls (16.84 ± 7.60 ng/ml vs. 4.12 ± 2.05 ng/ml, P<0.001). Patients with locally advanced and metastatic PCa had significantly higher serum EPCA level than those with clinically localized PCa (22.93 ± 5.28 ng/ml and 29.41 ± 8.47 ng/ml vs. 15.17 ± 6.03 ng/ml, P = 0.014 and P<0.001, respectively). Significantly elevated EPCA level was also found in metastatic PCa compared with locally advanced disease (P < 0.001). Increased serum EPCA levels were significantly and positively correlated with Gleason score and clinical stage, but not with PSA levels and age. On multivariate analysis, pretreatment serum EPCA level held the most significantly predictive value for the biochemical recurrence and androgen-independent progression among pretreatment variables (HR = 4.860, P<0.001 and HR = 5.418, P<0.001, respectively).
  
  
  CONCLUSIONS
  Serum EPCA level is markedly elevated in PCa. Pretreatment serum EPCA level correlates significantly with the poor prognosis, showing prediction potential for PCa progression.
authors.affiliation: Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical College, Guangdong Provincial Key Laboratory of Urology, Guangzhou, Guangdong Province, China. zgzhaodr@yahoo.com.cn
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Zhao
authors.forename: Wenjing
authors.initials: W
authors.lastname: Ma
authors.forename: Guohua
authors.initials: G
authors.lastname: Zeng
authors.forename: Defeng
authors.initials: D
authors.lastname: Qi
authors.forename: Lili
authors.initials: L
authors.lastname: Ou
authors.forename: Yeping
authors.initials: Y
authors.lastname: Liang
mesh_terms: D000368:Aged; D000951:Antigens, Neoplasm / Q000096:biosynthesis / Q000097:blood*; D016022:Case-Control Studies; D015331:Cohort Studies; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000208:ethnology*
chemical_list: D000951:Antigens, Neoplasm; C504719:early prostate cancer antigen, human