AUTHOR=McNally Christopher J. , Watt Joanne , Kurth Mary Jo , Lamont John V. , Moore Tara , Fitzgerald Peter , Pandha Hardev , McKenna Declan J. , Ruddock Mark W. 

TITLE=A Novel Combination of Serum Markers in a Multivariate Model to Help Triage Patients Into “Low-” and “High-Risk” Categories for Prostate Cancer

JOURNAL=Frontiers in Oncology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.837127

DOI=10.3389/fonc.2022.837127

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p>Almost 50,000 men in the United Kingdom (UK) are diagnosed each year with prostate cancer (PCa). Secondary referrals for investigations rely on serum prostate-specific antigen (PSA) levels and digital rectal examination. However, both tests lack sensitivity and specificity, resulting in unnecessary referrals to secondary care for costly and invasive biopsies.</p></sec><sec><title>Materials and Methods</title><p>Serum samples and clinical information were collected from <italic>N</italic> = 125 age-matched patients (<italic>n</italic> = 61 non-PCa and <italic>n</italic> = 64 PCa) and analyzed using Biochip Array Technology on high-sensitivity cytokine array I (IL-2, IL-4, IL-6, IL-8, IL-10, IL-1α, IL-1β, TNFα, MCP-1, INFγ, EGF, and VEGF), cerebral array II (CRP, D-dimer, neuron-specific enolase, and sTNFR1), and tumor PSA oncology array (fPSA, tPSA, and CEA).</p></sec><sec><title>Results</title><p>The data showed that 11/19 (68.8%) markers were significantly different between the non-PCa and the PCa patients. A combination of EGF, log<sub>10</sub> IL-8, log<sub>10</sub> MCP-1, and log<sub>10</sub> tPSA significantly improved the predictive potential of tPSA alone to identify patients with PCa (DeLong, <italic>p</italic> &lt; 0.001). This marker combination had an increased area under the receiver operator characteristic (0.860 <italic>vs</italic>. 0.700), sensitivity (78.7 <italic>vs</italic>. 68.9%), specificity (76.5 <italic>vs</italic>. 67.2%), PPV (76.2 <italic>vs</italic>. 66.7%), and NPV (79.0 <italic>vs</italic>. 69.4%) compared with tPSA.</p></sec><sec><title>Conclusions</title><p>The novel combination of serum markers identified in this study could be employed to help triage patients into “low-” and “high-risk” categories, allowing general practitioners to improve the management of patients in primary care settings and potentially reducing the number of referrals for unnecessary, invasive, and costly treatments.</p></sec>