Diagnostic ability of %p2PSA and prostate health index for aggressive prostate cancer: a meta-analysis.
The role of [-2]proPSA (p2PSA) based diagnostic tests for the detection of aggressive prostate cancer (PCa) has not been fully evaluated. We conducted a meta-analysis to evaluate the diagnostic performance of p2PSA/free PSA (%p2PSA) and prostate health index (Phi) tests for PCa and to evaluate their ability in discriminating between aggressive and non-aggressive PCa. A total of 16 articles were included in this meta-analysis. For the detection of PCa, the pooled sensitivity, specificity, and AUC were 0.86 (95% CI, 0.84-0.87), 0.40 (95% CI, 0.39-042) and 0.72 (95% CI, 0.67-0.77) for %p2PSA respectively, and were 0.85 (95% CI, 0.83-0.86), 0.45 (95% CI, 0.44-0.47) and 0.70 (95% CI=0.65-0.74) for Phi, respectively. In addition, the sensitivity for discriminating PCa between higher Gleason score (≥7) and lower Gleason score (<7) was 0.96 (95% CI, 0.93-0.98) and 0.90 (95% CI, 0.87-0.92) for %p2PSA and Phi respectively, and the specificity was low, only 0.09 (95% CI, 0.06-0.12) and 0.17 (95% CI, 0.14-0.19) for %p2PSA and Phi, respectively. Phi and %p2PSA have a high diagnostic accuracy rates and can be used in PCa diagnosis. Phi and %p2PSA may be useful as tumor markers in predicating patients harboring more aggressive disease and guiding biopsy decisions.
1] Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China [2] Center for Cancer Genomics, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA [3].
Wenying
W
Wang
1] Center for Cancer Genomics, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA [2].
Meilin
M
Wang
Center for Cancer Genomics, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Li
L
Wang
Center for Cancer Genomics, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Tamara S
TS
Adams
Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.
Ye
Y
Tian
Center for Cancer Genomics, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Jianfeng
J
Xu
D014408:Biomarkers, Tumor / Q000097:blood*; D016022:Case-Control Studies; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D020033:Protein Isoforms; D012372:ROC Curve; D012720:Severity of Illness Index
D014408:Biomarkers, Tumor; D020033:Protein Isoforms; D017430:Prostate-Specific Antigen