[-2]proPSA is an early marker for prostate cancer aggressiveness

Area of Science:

• Urology
• Oncology
• Biochemistry

Background:

• Prostate cancer (PCa) detection and management rely on accurate risk stratification.
• Preoperative markers are crucial for predicting disease aggressiveness and guiding treatment decisions.
• [-2]proPSA is a biomarker under investigation for its role in PCa assessment.

Purpose of the Study:

• To evaluate the correlation between preoperative [-2]proPSA levels and Gleason Score (GS).
• To assess the association between preoperative [-2]proPSA and the risk of non-organ-confined (NOC) disease in patients undergoing radical prostatectomy (RP).

Main Methods:

• Serum specimens from 381 patients in a PCa early detection program were analyzed using Beckman Coulter Access immunoassay.
• Inclusion criteria required at least three serum specimens over 4 years prior to diagnosis.
• [-2]proPSA values were correlated with GS and pathological stages from RP specimens.

Main Results:

• [-2]proPSA levels were significantly higher in PCa patients (n=208) compared to benign cases (n=173).
• Significant differences in [-2]proPSA between PCa and benign prostates were observed up to 4 years pre-diagnosis, with peak predictive value 1-2 years prior.
• Higher [-2]proPSA levels correlated with higher GS (≥GS8 vs ≤GS6) and increased risk of NOC disease, with significant predictive value 2-3 years pre-RP.

Conclusions:

• High preoperative [-2]proPSA levels are indicative of a greater risk of aggressive PCa.
• [-2]proPSA demonstrates significant predictive value for disease aggressiveness and extent.
• Incorporating [-2]proPSA into treatment decision-making for screen-detected PCa is recommended.