The Efficacy of Proclarix to Select Appropriate Candidates for Magnetic Resonance Imaging and Derived Prostate Biopsies in Men with Suspected Prostate Cancer.
Clinically significant
Diagnosis
Multiparametric magnetic resonance imaging
Proclarix
Prostate cancer
Journal
The world journal of men's health
ISSN: 2287-4208
Titre abrégé: World J Mens Health
Pays: Korea (South)
ID NLM: 101596899
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
08
07
2021
revised:
28
08
2021
accepted:
29
08
2021
pubmed:
13
1
2022
medline:
13
1
2022
entrez:
12
1
2022
Statut:
ppublish
Résumé
To analyze how Proclarix is valuable to appropriately select candidates for multiparametric magnetic resonance imaging (mpMRI) and derived biopsies, among men with suspected prostate cancer (PCa). Proclarix is a new marker computing the clinically significant PCa (csPCa) risk, based on serum thosmbospondin-1, cathepsin D, prostate-specific antigen (PSA) and percent free PSA, in addition to age, that has been developed in men with serum PSA 2 to 10 ng/mL, prostate volume ≥35 mL, and normal digital rectal examination (DRE). Proclarix score (0%-100%) is analyzed in a prospective frozen serum collection of 517 correlative men scheduled for guided and/or systematic biopsies after mpMRI. Outcome variables were csPCa detection (grade group ≥2), insignificant PCa (iPCa) overdetection and avoided mpMRIs. The area under the curve of Proclarix was 0.701 (95% CI 0.637-0.765) among 281 men with serum PSA 2 to 10 ng/mL, prostate volume ≥35 mL, and -normal DRE, and 0.754 (95% CI 0.701-0.807) in the others, p=0.038. Net benefit of Proclarix existed in all men. After selecting 10% threshold, Proclarix was integrated in an algorithm which also used the serum PSA level and DRE. A reduction of 25.4% of mpMRIs request was observed and 17.7% of prostate biopsies. Overdetection of iPCa was reduced in 18.2% and 2.6% of csPCa were misdiagnosed. Proclarix is valuable in all men with suspected PCa. An algorithm integrating Proclarix score, serum PSA, and DRE can avoid mpMRI requests, unnecessary prostate biopsies and iPCa overdetection, with minimal loss of csPCa detection.
Identifiants
pubmed: 35021312
pii: 40.e21
doi: 10.5534/wjmh.210117
pmc: PMC8987145
doi:
Types de publication
Journal Article
Langues
eng
Pagination
270-279Informations de copyright
Copyright © 2022 Korean Society for Sexual Medicine and Andrology.
Déclaration de conflit d'intérêts
The authors have nothing to disclose.
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