title: Effect of body mass index on the performance characteristics of PSA-related markers to detect prostate cancer.
abstract: To examine whether the predictive performance of prostate-specific antigen (PSA) and PSA-related markers for prostate cancer (PCa) is modified by body mass index (BMI). Patients with a PSA 2-10 ng/mL who underwent multicore prostate biopsies were recruited from three tertiary centers. Serum markers measured included total PSA (tPSA), free-to-total PSA (f/tPSA), p2PSA, percentage of p2PSA (%p2PSA), and prostate health index (PHI). The association between serum markers and PCa risk was assessed by logistic regression. Predictive performance for each marker was quantified using the area under the receiver operator curves (AUC). Among 516 men, 18.2% had PCa at biopsy. For all tested markers, their predictive value on PCa risk was lower in obese patients compared to normal weight patients. We found statistically significant interactions between BMI and tPSA (P = 0.0026) and p2PSA (P = 0.038). PHI achieved an AUC of 0.872 in normal weight patients and 0.745 in obese patients, which outperformed the other predictors regardless of BMI category. In conclusion, PHI achieved the best predictive performance for detecting PCa and was not influenced by BMI.
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Cheng-Tao
authors.initials: CT
authors.lastname: Han
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Gui-Ming
authors.initials: GM
authors.lastname: Zhang
authors.affiliation: State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, P.R. China.
authors.forename: Fang
authors.initials: F
authors.lastname: Liu
authors.affiliation: Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, P.R. China.|Department of Urology, Huashan Hospital, Fudan University, Shanghai, P.R. China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Ding
authors.affiliation: State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, P.R. China.|Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, P.R. China.|Department of Urology, Huashan Hospital, Fudan University, Shanghai, P.R. China.|Center for Genetic Epidemiology, School of Life Sciences, Fudan University, Shanghai, P.R. China.
authors.forename: Jian-Feng
authors.initials: JF
authors.lastname: Xu
authors.affiliation: Department of Surgery, Center for Integrated Research on Cancer and Lifestyle, Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, CA.
authors.forename: Adriana C
authors.initials: AC
authors.lastname: Vidal
authors.affiliation: Department of Surgery, Center for Integrated Research on Cancer and Lifestyle, Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, CA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Freedland
authors.affiliation: SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, P.R. China.
authors.forename: Chi-Fai
authors.initials: CF
authors.lastname: Ng
authors.affiliation: Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, P.R. China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
authors.forename: Ding-Wei
authors.initials: DW
authors.lastname: Ye
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D015992:Body Mass Index; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D012372:ROC Curve; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen