BERG, 500 Old Connecticut Path, Building B, Framingham, MA, 01701, USA.
Center for Prostate Disease Research, John P. Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences and the Walter Reed National Military Medical Center, Bethesda, MD, 20817, USA.
Sci Rep. 2021 Jul 23;11(1):15052. doi: 10.1038/s41598-021-94438-4.
Prostate-specific antigen (PSA) screening for prostate cancer (PCa) is limited by the lack of specificity but is further complicated in the benign prostatic hyperplasia (BPH) population which also exhibit elevated PSA, representing a clear unmet need to distinguish BPH from PCa. Herein, we evaluated the utility of FLNA IP-MRM, age, and prostate volume to stratify men with BPH from those with PCa. Diagnostic performance of the biomarker panel was better than PSA alone in discriminating patients with negative biopsy from those with PCa, as well as those who have had multiple prior biopsies (AUC 0.75 and 0.87 compared to AUC of PSA alone 0.55 and 0.57 for patients who have had single compared to multiple negative biopsies, respectively). Of interest, in patients with PCa, the panel demonstrated improved performance than PSA alone in those with Gleason scores of 5-7 (AUC 0.76 vs. 0.56) and Gleason scores of 8-10 (AUC 0.74 vs. 0.47). With Gleason scores (8-10), the negative predictive value of the panel is 0.97, indicating potential to limit false negatives in aggressive cancers. Together, these data demonstrate the ability of the biomarker panel to perform better than PSA alone in men with BPH, thus preventing unnecessary biopsies.
前列腺特异性抗原（PSA）筛查前列腺癌（PCa）的特异性有限，但在良性前列腺增生（BPH）人群中更为复杂，这些人群的 PSA 也升高，这明确表明需要一种方法将 BPH 与 PCa 区分开来。在此，我们评估了 FLNA IP-MRM、年龄和前列腺体积在区分 BPH 男性和 PCa 男性中的效用。与单独使用 PSA 相比，该生物标志物组合在区分阴性活检患者和 PCa 患者方面具有更好的诊断性能，以及那些已经进行了多次活检的患者（AUC 0.75 和 0.87 分别与 AUC 0.55 和 0.57 相比，对于那些已经进行了单一比较的患者）。有趣的是，在 PCa 患者中，与单独使用 PSA 相比，该组合在 Gleason 评分 5-7（AUC 0.76 与 0.56）和 Gleason 评分 8-10（AUC 0.74 与 0.47）的患者中表现出更好的性能。对于 Gleason 评分（8-10），该组合的阴性预测值为 0.97，表明有可能减少侵袭性癌症的假阴性。综上所述，这些数据表明，与单独使用 PSA 相比，该生物标志物组合在 BPH 男性中的诊断性能更好，从而可以避免不必要的活检。
