Department of Urology, Weill Cornell Medical College and New York Presbyterian Hospital, New York, New York.
Department of Urology, Universität Bern, Bern, Switzerland.
J Urol. 2017 Jul;198(1):42-49. doi: 10.1016/j.juro.2017.01.058. Epub 2017 Jan 20.
To our knowledge it is unknown whether urinary biomarkers for prostate cancer have added utility to clinical risk calculators in different racial groups. We examined the utility of urinary biomarkers added to clinical risk calculators for predicting prostate cancer in African American and nonAfrican American men.
Demographics, PCPT (Prostate Cancer Prevention Trial) risk scores, data on the biomarkers data PCA3 (prostate cancer antigen 3) and T2ERG (transmembrane protease serine 2 and v-ets erythroblastosis virus E26 oncogene homolog gene fusion), and biopsy pathology features were prospectively collected on 718 men as part of EDRN (Early Detection Research Network). Utility was determined by generating ROC curves and comparing AUC values for the baseline multivariable PCPT model and for models containing biomarker scores.
PCA3 and T2ERG added utility for the prediction of prostate cancer and clinically significant prostate cancer when combined with the PCPT Risk Calculator. This utility was seen in nonAfrican American men only for PCA3 (AUC 0.64 increased to 0.75 for prostate cancer and to 0.69-0.77 for clinically significant prostate cancer, both p <0.001) and for T2ERG (AUC 0.64-0.74 for prostate cancer, p <0.001, and 0.69-0.73 for clinically significant prostate cancer, p = 0.029). African American men did not have an added benefit with the addition of biomarkers, including PCA3 (AUC 0.75-0.77, p = 0.64, and 0.65-0.66, p = 0.74) and T2ERG (AUC 0.75-0.74, p = 0.74, and 0.65-0.64, p = 0.88), for prostate cancer and clinically significant prostate cancer, respectively. Limitations include the small number of African American men (72). The post hoc subgroup analysis nature of the study limited findings to being hypothesis generating.
As novel biomarkers are discovered, clinical utility should be established across demographically diverse cohorts.
据我们所知，目前尚不清楚尿生物标志物是否能为不同种族群体的临床风险计算器提供额外的帮助。我们研究了尿生物标志物在预测非裔美国人和非非裔美国男性前列腺癌中的临床风险计算器中的应用。
作为 EDRN（早期发现研究网络）的一部分，前瞻性地收集了 718 名男性的人口统计学资料、PCPT（前列腺癌预防试验）风险评分、生物标志物 PCA3（前列腺癌抗原 3）和 T2ERG（跨膜蛋白酶丝氨酸 2 和 v-ets 红细胞生成病毒 E26 致癌基因融合）的数据，以及活检病理特征。通过生成 ROC 曲线并比较基线多变量 PCPT 模型和包含生物标志物评分的模型的 AUC 值来确定效用。
PCA3 和 T2ERG 与 PCPT 风险计算器结合使用，可提高前列腺癌和临床显著前列腺癌的预测能力。这种效用仅在非裔美国男性中观察到 PCA3（AUC 从 0.64 增加到 0.75 用于前列腺癌，增加到 0.69-0.77 用于临床显著前列腺癌，均 p <0.001）和 T2ERG（AUC 0.64-0.74 用于前列腺癌，p <0.001，0.69-0.73 用于临床显著前列腺癌，p = 0.029）。非裔美国男性在加入生物标志物后并没有得到额外的益处，包括 PCA3（AUC 0.75-0.77，p = 0.64，和 0.65-0.66，p = 0.74）和 T2ERG（AUC 0.75-0.74，p = 0.74，和 0.65-0.64，p = 0.88），用于前列腺癌和临床显著前列腺癌，分别。局限性包括非裔美国男性人数较少（72 人）。研究的事后亚组分析性质限制了研究结果仅作为假设产生。
随着新的生物标志物的发现，应该在人口统计学上多样化的队列中建立临床效用。
