Clinical Use of [-2]proPSA (p2PSA) and Its derivatives (%p2PSA and prostate health index) for the detection of prostate cancer

A review of the literature

Alberto Abrate, Giovanni Lughezzani, Giulio Maria Gadda, Giuliana Lista, Ella Kinzikeeva, Nicola Fossati, Alessandro Larcher, Paolo Dell'Oglio, Francesco Mistretta, Nicolòmaria Buffi, Giorgio Guazzoni, Massimo Lazzeri

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Prostate-specific antigen (PSA) is recognizedas an organ-specific marker with low specificity and sensitivity in discriminating prostate cancer (PCa) from other benign conditions, such as prostatic hyperplasia or chronic prostatitis. Thus, in the case of clinical suspicion, a PCa diagnosis cannot be made without a prostate biopsy. [-2]proPSA (p2PSA), a precursor of PSA, has been investigated as a new marker to accurately detect PCa. The aim of this systematic review was to discuss the available literature regarding the clinical validity and utility of p2PSA and its derivatives, p2PSA/fPSA (%p2PSA) and the Prostate Health Index (PHI). A systematic search of the PubMed and Scopus electronic databases was performed in accordance with the PRISMA statement (http://www.prisma-statement.org), considering the time period from January 1990 to January 2014 and using the following search terms: proprostate specific antigen, proenzyme PSA, proPSA, [-2]proPSA, p2PSA, Prostate Health Index, and PHI. To date, 115 studies have been published, but only 35 were considered for the qualitative analysis. These studies suggested that p2PSA is the most cancer-specific form of PSA, being preferentially expressed in PCa tissue and being significantly elevated in the serum of men with PCa. It is now evident that p2PSA, %p2PSA, and PHI measurements improve the specificity of the available tests (PSA and derivatives) in detecting PCa. Moreover, increasing PHI values seem to correlate with more aggressive disease. Some studies have compared p2PSA and its derivatives with other new biomarkers and found p2PSA to be significantly more accurate. Indeed, the implementation of these tests in clinical practice has the potential to significantly increase the physician's ability to detect PCa and avoid unnecessary biopsies, while also having an effective impact on costs. Further studies in large, multicenter, prospective trials are required to confirm these encouraging results on the clinicalutility of these new biomarkers.

Original languageEnglish
Pages (from-to)436-445
Number of pages10
JournalKorean Journal of Urology
Volume55
Issue number7
DOIs
Publication statusPublished - 2014

Fingerprint

Prostate
Prostatic Neoplasms
Prostate-Specific Antigen
Health
Biomarkers
Biopsy
Prostatitis
Enzyme Precursors
Prostatic Hyperplasia
PubMed
Multicenter Studies
Databases
Physicians
Costs and Cost Analysis
Sensitivity and Specificity
Serum
Neoplasms

Keywords

  • Diagnosis
  • Prostate health index
  • Prostatecancer
  • [-2]proPSA

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

Cite this

Clinical Use of [-2]proPSA (p2PSA) and Its derivatives (%p2PSA and prostate health index) for the detection of prostate cancer : A review of the literature. / Abrate, Alberto; Lughezzani, Giovanni; Gadda, Giulio Maria; Lista, Giuliana; Kinzikeeva, Ella; Fossati, Nicola; Larcher, Alessandro; Dell'Oglio, Paolo; Mistretta, Francesco; Buffi, Nicolòmaria; Guazzoni, Giorgio; Lazzeri, Massimo.

In: Korean Journal of Urology, Vol. 55, No. 7, 2014, p. 436-445.

Research output: Contribution to journalArticle

Abrate, Alberto ; Lughezzani, Giovanni ; Gadda, Giulio Maria ; Lista, Giuliana ; Kinzikeeva, Ella ; Fossati, Nicola ; Larcher, Alessandro ; Dell'Oglio, Paolo ; Mistretta, Francesco ; Buffi, Nicolòmaria ; Guazzoni, Giorgio ; Lazzeri, Massimo. / Clinical Use of [-2]proPSA (p2PSA) and Its derivatives (%p2PSA and prostate health index) for the detection of prostate cancer : A review of the literature. In: Korean Journal of Urology. 2014 ; Vol. 55, No. 7. pp. 436-445.
@article{3421bb4e467b4b6291275449fc4c1eec,
title = "Clinical Use of [-2]proPSA (p2PSA) and Its derivatives ({\%}p2PSA and prostate health index) for the detection of prostate cancer: A review of the literature",
abstract = "Prostate-specific antigen (PSA) is recognizedas an organ-specific marker with low specificity and sensitivity in discriminating prostate cancer (PCa) from other benign conditions, such as prostatic hyperplasia or chronic prostatitis. Thus, in the case of clinical suspicion, a PCa diagnosis cannot be made without a prostate biopsy. [-2]proPSA (p2PSA), a precursor of PSA, has been investigated as a new marker to accurately detect PCa. The aim of this systematic review was to discuss the available literature regarding the clinical validity and utility of p2PSA and its derivatives, p2PSA/fPSA ({\%}p2PSA) and the Prostate Health Index (PHI). A systematic search of the PubMed and Scopus electronic databases was performed in accordance with the PRISMA statement (http://www.prisma-statement.org), considering the time period from January 1990 to January 2014 and using the following search terms: proprostate specific antigen, proenzyme PSA, proPSA, [-2]proPSA, p2PSA, Prostate Health Index, and PHI. To date, 115 studies have been published, but only 35 were considered for the qualitative analysis. These studies suggested that p2PSA is the most cancer-specific form of PSA, being preferentially expressed in PCa tissue and being significantly elevated in the serum of men with PCa. It is now evident that p2PSA, {\%}p2PSA, and PHI measurements improve the specificity of the available tests (PSA and derivatives) in detecting PCa. Moreover, increasing PHI values seem to correlate with more aggressive disease. Some studies have compared p2PSA and its derivatives with other new biomarkers and found p2PSA to be significantly more accurate. Indeed, the implementation of these tests in clinical practice has the potential to significantly increase the physician's ability to detect PCa and avoid unnecessary biopsies, while also having an effective impact on costs. Further studies in large, multicenter, prospective trials are required to confirm these encouraging results on the clinicalutility of these new biomarkers.",
keywords = "Diagnosis, Prostate health index, Prostatecancer, [-2]proPSA",
author = "Alberto Abrate and Giovanni Lughezzani and Gadda, {Giulio Maria} and Giuliana Lista and Ella Kinzikeeva and Nicola Fossati and Alessandro Larcher and Paolo Dell'Oglio and Francesco Mistretta and Nicol{\`o}maria Buffi and Giorgio Guazzoni and Massimo Lazzeri",
year = "2014",
doi = "10.4111/kju.2014.55.7.436",
language = "English",
volume = "55",
pages = "436--445",
journal = "Korean Journal of Urology",
issn = "2005-6737",
publisher = "Korean Urological Association",
number = "7",

}

TY - JOUR

T1 - Clinical Use of [-2]proPSA (p2PSA) and Its derivatives (%p2PSA and prostate health index) for the detection of prostate cancer

T2 - A review of the literature

AU - Abrate, Alberto

AU - Lughezzani, Giovanni

AU - Gadda, Giulio Maria

AU - Lista, Giuliana

AU - Kinzikeeva, Ella

AU - Fossati, Nicola

AU - Larcher, Alessandro

AU - Dell'Oglio, Paolo

AU - Mistretta, Francesco

AU - Buffi, Nicolòmaria

AU - Guazzoni, Giorgio

AU - Lazzeri, Massimo

PY - 2014

Y1 - 2014

N2 - Prostate-specific antigen (PSA) is recognizedas an organ-specific marker with low specificity and sensitivity in discriminating prostate cancer (PCa) from other benign conditions, such as prostatic hyperplasia or chronic prostatitis. Thus, in the case of clinical suspicion, a PCa diagnosis cannot be made without a prostate biopsy. [-2]proPSA (p2PSA), a precursor of PSA, has been investigated as a new marker to accurately detect PCa. The aim of this systematic review was to discuss the available literature regarding the clinical validity and utility of p2PSA and its derivatives, p2PSA/fPSA (%p2PSA) and the Prostate Health Index (PHI). A systematic search of the PubMed and Scopus electronic databases was performed in accordance with the PRISMA statement (http://www.prisma-statement.org), considering the time period from January 1990 to January 2014 and using the following search terms: proprostate specific antigen, proenzyme PSA, proPSA, [-2]proPSA, p2PSA, Prostate Health Index, and PHI. To date, 115 studies have been published, but only 35 were considered for the qualitative analysis. These studies suggested that p2PSA is the most cancer-specific form of PSA, being preferentially expressed in PCa tissue and being significantly elevated in the serum of men with PCa. It is now evident that p2PSA, %p2PSA, and PHI measurements improve the specificity of the available tests (PSA and derivatives) in detecting PCa. Moreover, increasing PHI values seem to correlate with more aggressive disease. Some studies have compared p2PSA and its derivatives with other new biomarkers and found p2PSA to be significantly more accurate. Indeed, the implementation of these tests in clinical practice has the potential to significantly increase the physician's ability to detect PCa and avoid unnecessary biopsies, while also having an effective impact on costs. Further studies in large, multicenter, prospective trials are required to confirm these encouraging results on the clinicalutility of these new biomarkers.

AB - Prostate-specific antigen (PSA) is recognizedas an organ-specific marker with low specificity and sensitivity in discriminating prostate cancer (PCa) from other benign conditions, such as prostatic hyperplasia or chronic prostatitis. Thus, in the case of clinical suspicion, a PCa diagnosis cannot be made without a prostate biopsy. [-2]proPSA (p2PSA), a precursor of PSA, has been investigated as a new marker to accurately detect PCa. The aim of this systematic review was to discuss the available literature regarding the clinical validity and utility of p2PSA and its derivatives, p2PSA/fPSA (%p2PSA) and the Prostate Health Index (PHI). A systematic search of the PubMed and Scopus electronic databases was performed in accordance with the PRISMA statement (http://www.prisma-statement.org), considering the time period from January 1990 to January 2014 and using the following search terms: proprostate specific antigen, proenzyme PSA, proPSA, [-2]proPSA, p2PSA, Prostate Health Index, and PHI. To date, 115 studies have been published, but only 35 were considered for the qualitative analysis. These studies suggested that p2PSA is the most cancer-specific form of PSA, being preferentially expressed in PCa tissue and being significantly elevated in the serum of men with PCa. It is now evident that p2PSA, %p2PSA, and PHI measurements improve the specificity of the available tests (PSA and derivatives) in detecting PCa. Moreover, increasing PHI values seem to correlate with more aggressive disease. Some studies have compared p2PSA and its derivatives with other new biomarkers and found p2PSA to be significantly more accurate. Indeed, the implementation of these tests in clinical practice has the potential to significantly increase the physician's ability to detect PCa and avoid unnecessary biopsies, while also having an effective impact on costs. Further studies in large, multicenter, prospective trials are required to confirm these encouraging results on the clinicalutility of these new biomarkers.

KW - Diagnosis

KW - Prostate health index

KW - Prostatecancer

KW - [-2]proPSA

UR - http://www.scopus.com/inward/record.url?scp=84904397983&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84904397983&partnerID=8YFLogxK

U2 - 10.4111/kju.2014.55.7.436

DO - 10.4111/kju.2014.55.7.436

M3 - Article

VL - 55

SP - 436

EP - 445

JO - Korean Journal of Urology

JF - Korean Journal of Urology

SN - 2005-6737

IS - 7

ER -