Wang Wenying, Wang Meilin, Wang Li, Adams Tamara S, Tian Ye, Xu Jianfeng
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].
1] Center for Cancer Genomics, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA [2].
Sci Rep. 2014 May 23;4:5012. doi: 10.1038/srep05012.
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.
基于[-2]前列腺特异性抗原（p2PSA）的诊断测试在检测侵袭性前列腺癌（PCa）中的作用尚未得到充分评估。我们进行了一项荟萃分析，以评估p2PSA/游离前列腺特异性抗原（%p2PSA）和前列腺健康指数（Phi）测试对PCa的诊断性能，并评估它们区分侵袭性和非侵袭性PCa的能力。本荟萃分析共纳入16篇文章。对于PCa的检测，%p2PSA的合并敏感性、特异性和曲线下面积（AUC）分别为0.86（95%置信区间，0.84 - 0.87）、0.40（95%置信区间，0.39 - 0.42）和0.72（95%置信区间，0.67 - 0.77），Phi的分别为0.85（95%置信区间，0.83 - 0.86）、0.45（95%置信区间，0.44 - 0.47）和0.70（95%置信区间 = 0.65 - 0.74）。此外，对于区分高Gleason评分（≥7）和低Gleason评分（<7）的PCa，%p2PSA和Phi的敏感性分别为0.96（95%置信区间，0.93 - 0.98）和0.90（95%置信区间，0.87 - 0.92），而特异性较低，%p2PSA和Phi的分别仅为0.09（95%置信区间，0.06 - 0.12）和0.17（95%置信区间，0.14 - 0.19）。Phi和%p2PSA具有较高的诊断准确率，可用于PCa诊断。Phi和%p2PSA作为肿瘤标志物在预测患有更侵袭性疾病的患者和指导活检决策方面可能有用。
