Abstract
You have accessJournal of UrologyProstate Cancer: Markers I1 Apr 2014MP74-11 PRE-SURGICAL EXPRESSED PROSTATIC SECRETION BIOMARKER PERFORMANCE IN THE DETECTION OF GLEASON UPGRADING IN PROSTATE CANCER. Kristina Wittig, Jonathan Yamzon, David Smith, Clayton Lau, Mark Kawachi, Timothy Wilson, and Steven Smith Kristina WittigKristina Wittig More articles by this author , Jonathan YamzonJonathan Yamzon More articles by this author , David SmithDavid Smith More articles by this author , Clayton LauClayton Lau More articles by this author , Mark KawachiMark Kawachi More articles by this author , Timothy WilsonTimothy Wilson More articles by this author , and Steven SmithSteven Smith More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2344AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES New approaches to improve risk stratification for active surveillance in patients diagnosed with localized prostate cancer involve the use of molecular-based techniques. We sought to assess the performance of novel biomarkers present in pre-surgical expressed prostatic secretion (EPS) in predicting Gleason upgrading in a cohort of men who underwent radical prostatectomy (RP). METHODS EPS specimens were obtained before robot-assisted RP. Standard clinico-pathologic data (age, Gleason sum, pre-surgical prostate specific antigen (PSA)), directly measured secretion capacity biomarkers (EPS volume, total recovered RNA), and molecular biomarkers tested with quantitative reverse transcription polymerase chain reaction biomarkers (TMPRSS2:ERG, TXNDR1, PCA3, PSA) were measured. Receiver Operator Characteristic (ROC) analysis of clinico-pathologic and biomarker variables was carried out in an attempt to predict upgrading. A minimal model emerged from serial least significant variable elimination on a preliminary set of 26 biomarker transformations. RESULTS EPS was collected in 528 men who underwent RP with complete clinical and pathologic data. ROC analysis for predicting Gleason score upgrading yielded a model containing biopsy Gleason sum, pre-surgical serum PSA and recovered EPS volume, with an area under the curve (AUC) of 0.83 (Table 1). CONCLUSIONS In this cohort of men, models for predicting upgrading are dominated by the standard clinico-pathologic parameters, with marginal contribution from recovered EPS volume, and no significant contribution from molecular biomarkers tested. Although the performance of the test in assigning a probability of upgrading is high, it cannot make a significant contribution to patient selection for active surveillance since it is dominated by the high probability (49%) that Gleason six patients will be upgraded to Gleason 7 compared to the low probability (5%) that Gleason 7 or greater patients will be upgraded based on pathology. Gleason Grade Total Number Biopsy Gleason Grade: Probability (P) {upgrade} P {upgrade} All 524 All P {any upgrade} 0.240 6 229 6: P {any upgrade} 0.485 6 10 6: P {upgrade to 4+3} 0.044 6 101 6: P {upgrade to 3+4} 0.441 7 7 7:P {upgrade to 8 or 9} 0.027 8 8 8:P {upgrade to 9} 0.242 9 9 9: P {upgrade to 10} 0 © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e860 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Kristina Wittig More articles by this author Jonathan Yamzon More articles by this author David Smith More articles by this author Clayton Lau More articles by this author Mark Kawachi More articles by this author Timothy Wilson More articles by this author Steven Smith More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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