Abstract
Prostate Specific Antigen (PSA) is the most commonly used serum marker for prostate cancer (PCa), although it is not specific and sensitive enough to allow the differential diagnosis of the more aggressive tumors. For that, new diagnostic methods are being developed, such as PCA-3, PSA isoforms that have resulted in the 4K score or the Prostate Health Index (PHI), and PSA glycoforms. In the present study, we have compared the PHI with our recently developed PSA glycoform assay, based on the determination of the α2,3-sialic acid percentage of serum PSA (% α2,3-SA), in a cohort of 79 patients, which include 50 PCa of different grades and 29 benign prostate hyperplasia (BPH) patients. The % α2,3-SA could distinguish high-risk PCa patients from the rest of patients better than the PHI (area under the curve (AUC) of 0.971 vs. 0.840), although the PHI correlated better with the Gleason score than the % α2,3-SA. The combination of both markers increased the AUC up to 0.985 resulting in 100% sensitivity and 94.7% specificity to differentiate high-risk PCa from the other low and intermediate-risk PCa and BPH patients. These results suggest that both serum markers complement each other and offer an improved diagnostic tool to identify high-risk PCa, which is an important requirement for guiding treatment decisions.
Highlights
Prostate cancer (PCa) is an important problem in public health and a major disease that affects men’s health worldwide
We have developed a methodology to quantify the ratio of core fucosylation of serum Prostate Specific Antigen (PSA) and the percentage of α2,3-sialic acid of serum PSA and have shown a decrease in the content of core fucose and an increase in α2,3-sialic acid of PSA N-glycans in patients with high-risk PCa [9]
A cohort of 79 serum samples containing 29 benign prostate hyperplasia (BPH) and 50 PCa samples was used for the study of the two blood-based biomarkers, Prostate Health Index (PHI) and the percentage of α2,3-sialic of PSA
Summary
Prostate cancer (PCa) is an important problem in public health and a major disease that affects men’s health worldwide. It was the most commonly diagnosed male neoplasia in western countries and Japan last year. Since PCa has a long natural history, the PSA assay predicts a prostate pathology decades before a confirmatory diagnostic [3]. This means that a majority of men diagnosed with PCa could be detected at early stages and with localized prostate cancer. Epidemiologic studies indicate an important and continuous decrease in prostate cancer mortality since the application of the PSA screening test [4]
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