title: Urinary Biomarker Panel to Improve Accuracy in Predicting Prostate Biopsy Result in Chinese Men with PSA 4-10 ng/mL.
abstract: This study aims to evaluate the effectiveness and clinical performance of a panel of urinary biomarkers to diagnose prostate cancer (PCa) in Chinese men with PSA levels between 4 and 10 ng/mL. A total of 122 patients with PSA levels between 4 and 10 ng/mL who underwent consecutive prostate biopsy at three hospitals in China were recruited. First-catch urine samples were collected after an attentive prostate massage. Urinary mRNA levels were measured by quantitative real-time polymerase chain reaction (qRT-PCR). The predictive accuracy of these biomarkers and prediction models was assessed by the area under the curve (AUC) of the receiver-operating characteristic (ROC) curve. The diagnostic accuracy of PCA3, PSGR, and MALAT-1 was superior to that of PSA. PCA3 performed best, with an AUC of 0.734 (95% CI: 0.641, 0.828) followed by MALAT-1 with an AUC of 0.727 (95% CI: 0.625, 0.829) and PSGR with an AUC of 0.666 (95% CI: 0.575, 0.749). The diagnostic panel with age, prostate volume, % fPSA, PCA3 score, PSGR score, and MALAT-1 score yielded an AUC of 0.857 (95% CI: 0.780, 0.933). At a threshold probability of 20%, 47.2% of unnecessary biopsies may be avoided whereas only 6.2% of PCa cases may be missed. This urinary panel may improve the current diagnostic modality in Chinese men with PSA levels between 4 and 10 ng/mL.
authors.affiliation: Department of Urology, The People's Hospital of Wujiang City, Suzhou, Jiangsu, China.
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Urology, Shanghai Shibei Hospital of Jingan District, Shanghai, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, The Third People's Hospital of Yancheng, Yancheng, Jiangsu, China.
authors.forename: Xiangnan
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Urology, The People's Hospital of Wujiang City, Suzhou, Jiangsu, China.
authors.forename: Minjun
authors.identifier: 0000-0002-0661-9272
authors.initials: M
authors.lastname: Jiang
mesh_terms: D000368:Aged; D000465:Algorithms; D014408:Biomarkers, Tumor / Q000652:urine*; D001706:Biopsy; D002681:China; D006801:Humans; D008297:Male; D008875:Middle Aged; D011336:Probability; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000652:urine*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000652:urine*; D012372:ROC Curve; D060888:Real-Time Polymerase Chain Reaction; D012044:Regression Analysis; D015203:Reproducibility of Results; D012720:Severity of Illness Index
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen