Premium
Serum human glandular kallikrein (hK2) and insulin‐like growth factor 1 (IGF‐1) improve the discrimination between prostate cancer and benign prostatic hyperplasia in combination with total and %free PSA
Author(s) -
Scorilas Andreas,
Plebani Mario,
Mazza Saverio,
Basso Daniela,
Soosaipillai Antoninus R.,
Katsaros Nikos,
Pagano Francesco,
Diamandis Eleftherios P.
Publication year - 2002
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.10186
Subject(s) - medicine , prostate cancer , prostate , hyperplasia , univariate analysis , logistic regression , urology , prostate specific antigen , oncology , receiver operating characteristic , cancer , insulin like growth factor , multivariate analysis , endocrinology , growth factor , receptor
BACKGROUND There is growing evidence describing an association of hK2 and IGFs with cancer. The aim of this study is to investigate the differences in serum levels of hK2 and IGFs in a large group of patients with benign prostatic hyperplasia (BPH) or prostatic carcinoma (CaP) and to examine the value of these variables, as well as their various combinations with PSA, for discriminating between these two clinical entities. METHODS Human glandular kallikrein 2 (hK2), insulin‐like growth factor‐1 (IGF‐1), free and total PSA concentrations were measured with non‐competitive immunological procedures. Receiver operating characteristic (ROC) analysis as well as univariate and multivariate logistic regression analysis were performed to investigate the potential utility of the various markers and their combinations for discriminating between BPH and CaP. RESULTS hK2 and IGF‐1 concentrations were increased in CaP patients, in comparison to BPH patients. hK2/free PSA and free/total PSA ratios (area under the curve, AUC = 0.70) were stronger predictors of prostate cancer than the IGF‐1/total PSA ratio (AUC = 0.56) in the group of patients with total PSA <4 μg/L. The hK2/free PSA ratio (AUC = 0.74) was found to have significant discriminatory value in patients with total PSA within the “gray zone” (4–10 μg/L). Multivariate logistic regression models confirmed the observed relationships and identified IGF‐1/free PSA and hK2/free PSA as independent predictors of CaP. CONCLUSIONS hK2/free PSA and IGF‐1/free PSA ratios may be useful adjuncts in improving patient selection for prostate biopsy. Prostate 54: 220–229, 2003. © 2002 Wiley‐Liss, Inc.