Prospective validation of microseminoprotein-β added to the 4Kscore in predicting high-grade prostate cancer in an international multicentre cohort Journal Article

   

Authors:	Lonergan, P. E.; Vertosick, E. A.; Assel, M.; Sjoberg, D. D.; Haese, A.; Graefen, M.; Boorjian, S. A.; Klee, G. G.; Cooperberg, M. R.; Pettersson, K.; Routila, E.; Vickers, A. J.; Lilja, H.
Article Title:	Prospective validation of microseminoprotein-β added to the 4Kscore in predicting high-grade prostate cancer in an international multicentre cohort
Abstract:	Objectives: To prospectively evaluate the performance of a pre-specified statistical model based on four kallikrein markers in blood (total prostate-specific antigen [PSA], free PSA, intact PSA, and human kallikrein-related peptidase 2), commercially available as the 4Kscore, in predicting Gleason Grade Group (GG) ≥2 prostate cancer at biopsy in an international multicentre study at three academic medical centres, and whether microseminoprotein-β (MSP) adds predictive value. Patients and Methods: A total of 984 men were prospectively enrolled at three academic centres. The primary outcome was GG ≥2 on prostate biopsy. Three pre-specified statistical models were used: a base model including PSA, age, digital rectal examination and prior negative biopsy; a model that added free PSA to the base model; and the 4Kscore. Results: A total of 947 men were included in the final analysis and 273 (29%) had GG ≥2 on prostate biopsy. The base model area under the receiver operating characteristic curve of 0.775 increased to 0.802 with the addition of free PSA, and to 0.824 for the 4Kscore. Adding MSP to the 4Kscore model yielded an increase (0.014–0.019) in discrimination. In decision-curve analysis of clinical utility, the 4Kscore showed a benefit starting at a 7.5% threshold. Conclusion: A prospective multicentre evaluation of a pre-specified model based on four kallikrein markers (4Kscore) with the addition of MSP improves the predictive discrimination for GG ≥2 prostate cancer on biopsy and could be used to inform biopsy decision-making. © 2020 The Authors BJU International © 2020 BJU International Published by John Wiley & Sons Ltd
Keywords:	prostate-specific antigen; prostate biopsy; kallikreins; 4kscore; #pcsm; #prostatecancer; #uroonc; microseminoprotein-β
Journal Title:	BJU International
Volume:	128
Issue:	2
ISSN:	1464-4096
Publisher:	Wiley Blackwell
Date Published:	2021-08-01
Start Page:	218
End Page:	224
Language:	English
DOI:	10.1111/bju.15320
PUBMED:	33306251
PROVIDER:	scopus
PMCID:	PMC8279428
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85098172819&doi=10.1111%2fbju.15320&partnerID=40&md5=680f59113237df4385de38cf1e60b742
Notes:	Article -- Export Date: 1 September 2021 -- Source: Scopus

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