Prostate specific antigen isoforms and human glandular kallikrein 2 - Which offers the best screening performance in a predominantly black population?

B. J. Martin, C. D. Cheli, K. Sterling, M. Ward, S. Pollard, D. Lifsey, D. Mercante, L. Martin, Walter Rayford

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Purpose: Free prostate specific antigen, complexed PSA and human glandular kallikrein 2 have independently been tested against the gold standard of total PSA for prostate cancer screening in largely white populations. With the incidence of prostate cancer much higher in black men, we sought to evaluate these markers simultaneously in a predominantly black population. Materials and Methods: A total of 138 men, of whom 108 were black, underwent ultrasound guided biopsy of the prostate for tPSA levels greater than 2.5 ng/ml or an abnormal digital rectal examination. Sera were drawn before biopsy and analyzed for tPSA, fPSA, cPSA and hK2 concentrations using standard methods (hK2 assay is for research use only, not for use in diagnostic procedures). The areas under the receiver operator characteristic curves were determined for each marker as well as biomarker combinations. Additionally, each parameter's specificity, positive and negative predictive values, and theoretical screening efficiency were assessed at or above the 95% sensitivity level. Results: A total of 43 (31.1%) men had prostate cancer by biopsy. While the AUC for %fPSA was statistically the highest (0.822, p <0.001), cPSA offered the highest specificity (31.6%) and positive predictive power (31.7%) of any of the tested biomarkers at comparable sensitivity (greater than 95%). The calculated efficiency of cPSA (51.4%) was also higher than the other markers. Nearly 20% of biopsies would be avoided using cPSA vs standard tPSA screening methods. Conclusions: Comparing the major PSA isoforms and hK2, cPSA alone appears to offer superior diagnostic discrimination for cancer detection in a predominantly black population.

Original languageEnglish (US)
Pages (from-to)104-107
Number of pages4
JournalJournal of Urology
Volume175
Issue number1
DOIs
StatePublished - Jan 1 2006
Externally publishedYes

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Tissue Kallikreins
Prostate-Specific Antigen
Protein Isoforms
Biopsy
Prostatic Neoplasms
Population
Biomarkers
Digital Rectal Examination
Early Detection of Cancer
Area Under Curve
Prostate
Incidence
Serum
Research
Neoplasms

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Prostate specific antigen isoforms and human glandular kallikrein 2 - Which offers the best screening performance in a predominantly black population? / Martin, B. J.; Cheli, C. D.; Sterling, K.; Ward, M.; Pollard, S.; Lifsey, D.; Mercante, D.; Martin, L.; Rayford, Walter.

In: Journal of Urology, Vol. 175, No. 1, 01.01.2006, p. 104-107.

Research output: Contribution to journalArticle

Martin, B. J. ; Cheli, C. D. ; Sterling, K. ; Ward, M. ; Pollard, S. ; Lifsey, D. ; Mercante, D. ; Martin, L. ; Rayford, Walter. / Prostate specific antigen isoforms and human glandular kallikrein 2 - Which offers the best screening performance in a predominantly black population?. In: Journal of Urology. 2006 ; Vol. 175, No. 1. pp. 104-107.
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