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del Pino-Sedeño T, Infante-Ventura D, de Armas Castellano A, de Pablos-Rodríguez P, Rueda-Domínguez A, Serrano-Aguilar P, Trujillo-Martín MM. Molecular Biomarkers for the Detection of Clinically Significant Prostate Cancer: A Systematic Review and Meta-analysis. EUR UROL SUPPL 2022; 46:105-127. [PMID: 36388432 PMCID: PMC9664479 DOI: 10.1016/j.euros.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 11/11/2022] Open
Abstract
Context Prostate cancer (PCa) is the second most common type of cancer in men. Individualized risk stratification is crucial to adjust decision-making. A variety of molecular biomarkers have been developed in order to identify patients at risk of clinically significant PCa (csPCa) defined by the most common PCa risk stratification systems. Objective The present study aims to examine the effectiveness (diagnostic accuracy) of blood or urine-based PCa biomarkers to identify patients at high risk of csPCa. Evidence acquisition A systematic review of the literature was conducted. Medline and EMBASE were searched from inception to March 2021. Randomized or nonrandomized clinical trials, and cohort and case-control studies were eligible for inclusion. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Pooled estimates of sensitivity, specificity, and area under the curve were obtained. Evidence synthesis Sixty-five studies (N = 34 287) were included. Not all studies included prostate-specific antigen-selected patients. The pooled data showed that the Prostate Health Index (PHI), with any cutoff point between 15 and 30, had sensitivity of 0.95-1.00 and specificity of 0.14-0.33 for csPCa detection. The pooled estimates for SelectMDx test sensitivity and specificity were 0.84 and 0.49, respectively. Conclusions The PHI test has a high diagnostic accuracy rate for csPCa detection, and its incorporation in the diagnostic process could reduce unnecessary biopsies. However, there is a lack of evidence on patient-important outcomes and thus more research is needed. Patient summary It has been possible to verify that the application of biomarkers could help detect prostate cancer (PCa) patients with a higher risk of poorer evolution. The Prostate Health Index shows an ability to identify 95-100 for every 100 patients suffering from clinically significant PCa who take the test, preventing unnecessary biopsies in 14-33% of men without PCa or insignificant PCa.
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Affiliation(s)
- Tasmania del Pino-Sedeño
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
- European University of the Canary Islands (UEC), Santa Cruz de Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
| | - Diego Infante-Ventura
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | - Aythami de Armas Castellano
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | - Pedro de Pablos-Rodríguez
- Department of Urology, Valencian Institute of Oncology Foundation, Valencia, Spain
- Doctoral School of University of Las Palmas de Gran Canaria, Las Palmas, Spain
- Research Institute of Biochemical and Health Sciences, Barcelona, Spain
| | - Antonio Rueda-Domínguez
- Medical Oncology Intercenter Unit, Regional and Virgen de la Victoria University Hospitals, IBIMA, Málaga, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain
| | - Pedro Serrano-Aguilar
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain
- Institute of Biomedical Technologies (ITB). University of La Laguna, Tenerife, Spain
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain
| | - María M. Trujillo-Martín
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Tenerife, Spain
- Research Network on Health Services in Chronic Diseases (REDISSEC), Madrid, Spain
- Institute of Biomedical Technologies (ITB). University of La Laguna, Tenerife, Spain
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Jia W, Wu B, Shao Y, Cao X, Wang D. Diagnostic performance of prostate cancer antigen 3 and the Prostate Health Index in detecting overall and clinically significant prostate cancer in men at first biopsy: A meta-analysis. Int J Urol 2021; 28:315-325. [PMID: 33336418 DOI: 10.1111/iju.14464] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 11/09/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To evaluate the diagnostic value of prostate cancer antigen 3 and the Prostate Health Index for the detection of overall and clinically significant prostate cancer at initial biopsy. METHODS A search was conducted in the online databases PubMed, Embase and the Cochrane database, and relevant articles published up to 23 February 2020 were extracted. RESULTS Twenty studies including 10 376 patients were included in the meta-analysis. The pooled sensitivity and specificity were 0.55 (95% confidence interval 0.53-0.57) and 0.74 (95% confidence interval 0.72-0.75) for prostate cancer antigen 3 and 0.88 (95% confidence interval 0.86-0.90) and 0.36 (95% confidence interval 0.34-0.38) for the Prostate Health Index. The area under the curve was 0.72 for prostate cancer antigen 3 and 0.76 for the Prostate Health Index. The combination of prostate cancer antigen 3 and the Prostate Health Index had a higher area under the curve (0.79) and diagnostic odds ratio (5.83) than the use of Prostate Health Index (area under the curve 0.75, diagnostic odds ratio 4.69) or prostate cancer antigen 3 (area under the curve 0.77, diagnostic odds ratio 4.84) alone. For clinically significant prostate cancer detection, the pooled sensitivity and specificity were 0.80 (95% confidence interval 0.76-0.84) and 0.53 (95% confidence interval 0.50-0.55), respectively, for prostate cancer antigen 3, and 0.77 (95% confidence interval 0.71-0.82) and 0.64 (95% confidence interval 0.61-0.67), respectively, for the Prostate Health Index. The area under the curve was 0.71 for prostate cancer antigen 3 and 0.77 for the Prostate Health Index. CONCLUSION Both the Prostate Health Index and prostate cancer antigen 3 showed acceptable and similar results for the detection of overall and clinically significant prostate cancer at first biopsy. A combination of these two diagnostic tests may be more helpful than the use of either test alone in prostate cancer management.
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Affiliation(s)
- Wei Jia
- Shanxi Medical University, Taiyuan, Shanxi, China
| | - Bo Wu
- Shanxi Medical University, Taiyuan, Shanxi, China
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yuan Shao
- Shanxi Medical University, Taiyuan, Shanxi, China
| | - Xiaoming Cao
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Dongwen Wang
- Shanxi Medical University, Taiyuan, Shanxi, China
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, Guangdong, China
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3
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Qin Z, Yao J, Xu L, Xu Z, Ge Y, Zhou L, Zhao F, Jia R. Diagnosis accuracy of PCA3 level in patients with prostate cancer: a systematic review with meta-analysis. Int Braz J Urol 2020; 46:691-704. [PMID: 31961625 PMCID: PMC7822358 DOI: 10.1590/s1677-5538.ibju.2019.0360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 10/13/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The diagnostic value and suitability of prostate cancer antigen 3 (PCA3) for the detection of prostate cancer (PCa) have been inconsistent in previous studies. Thus, the aim of the present meta-analysis was performed to systematically evaluate the diagnostic value of PCA3 for PCa. MATERIALS AND METHODS A meta-analysis was performed to search relevant studies using online databases EMBASE, PubMed and Web of Science published until February 1st, 2019. Ultimately, 65 studies met the inclusion criteria for this meta-analysis with 8.139 cases and 14.116 controls. The sensitivity, specificity, positive likelihood ratios (LR+), negative likelihood ratios (LR-), and other measures of PCA3 were pooled and determined to evaluate the diagnostic rate of PCa by the random-effect model. RESULTS With PCA3, the pooled overall diagnostic sensitivity, specificity, LR+, LR-, and 95% confidence intervals (CIs) for predicting significant PCa were 0.68 (0.64-0.72), 0.72 (0.68-0.75), 2.41 (2.16-2.69), 0.44 (0.40-0.49), respectively. Besides, the summary diagnostic odds ratio (DOR) and 95% CIs for PCA3 was 5.44 (4.53-6.53). In addition, the area under summary receiver operating characteristic (sROC) curves and 95% CIs was 0.76 (0.72-0.79). The major design deficiencies of included studies were differential verification bias, and a lack of clear inclusion and exclusion criteria. CONCLUSIONS The results of this meta-analysis suggested that PCA3 was a non-invasive method with the acceptable sensitivity and specificity in the diagnosis of PCa, to distinguish between patients and healthy individuals. To validate the potential applicability of PCA3 in the diagnosis of PCa, more rigorous studies were needed to confirm these conclusions.
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Affiliation(s)
- Zhiqiang Qin
- Department of Urology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jianxiang Yao
- Department of Urology, Huzhou first people's hospital, Huzhou, China
| | - Luwei Xu
- Department of Urology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Zheng Xu
- Department of Urology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yuzheng Ge
- Department of Urology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Liuhua Zhou
- Department of Urology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Feng Zhao
- Department of Urology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Ruipeng Jia
- Department of Urology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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Lemos AEG, Matos ADR, Ferreira LB, Gimba ERP. The long non-coding RNA PCA3: an update of its functions and clinical applications as a biomarker in prostate cancer. Oncotarget 2019; 10:6589-6603. [PMID: 31762940 PMCID: PMC6859920 DOI: 10.18632/oncotarget.27284] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 09/24/2019] [Indexed: 02/07/2023] Open
Abstract
Prostate cancer antigen 3 (PCA3) is an overexpressed prostate long non-coding RNA (lncRNA), transcribed from an intronic region at the long arm of human chromosome 9q21–22. It has been described that PCA3 modulates prostate cancer (PCa) cell survival through modulating androgen receptor (AR) signaling, besides controlling the expression of several androgen responsive and cancer-related genes, including epithelial–mesenchymal transition (EMT) markers and those regulating gene expression and cell signaling. Also, PCA3 urine levels have been successfully used as a PCa diagnostic biomarker. In this review, we have highlighted recent findings regarding PCA3, addressing its gene structure, putative applications as a biomarker, a proposed origin of this lncRNA, roles in PCa biology and expression patterns. We also updated data regarding PCA3 interactions with cancer-related miRNAs and expression in other tissues and diseases beyond the prostate. Altogether, literature data indicate aberrant expression and dysregulated activity of PCA3, suggesting PCA3 as a promising relevant target that should be even further evaluated on its applicability for PCa detection and management.
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Affiliation(s)
- Ana Emília Goulart Lemos
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública/Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil.,Programa de Pós-Graduação em Ciências Biomédicas - Fisiologia e Farmacologia, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | - Aline da Rocha Matos
- Laboratório de Vírus Respiratórios e do Sarampo, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
| | | | - Etel Rodrigues Pereira Gimba
- Programa de Pós-Graduação em Ciências Biomédicas - Fisiologia e Farmacologia, Universidade Federal Fluminense, Rio de Janeiro, Brazil.,Coordenação de Pesquisa, Instituto Nacional do Câncer, Rio de Janeiro, Brazil.,Departamento de Ciências da Natureza (RCN), Instituto de Humanidades e Saúde, Universidade Federal Fluminense, Rio de Janeiro, Brazil
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Liu Z, Chang Q, Yang F, Liu B, Yao HW, Bai ZG, Pu CS, Ma XM, Yang Y, Wang TT, Guo W, Zhou XN, Zhang ZT. Long non-coding RNA NEAT1 overexpression is associated with unfavorable prognosis in patients with hepatocellular carcinoma after hepatectomy: A Chinese population-based study. Eur J Surg Oncol 2017; 43:1697-1703. [PMID: 28732670 DOI: 10.1016/j.ejso.2017.06.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 05/30/2017] [Accepted: 06/08/2017] [Indexed: 01/16/2023] Open
Abstract
AIM To identify the association between the expression of lncRNA NEAT1 and clinicopathological characteristics of patients with HCC, and to explore the prognostic significance of lncRNA NEAT1 in predicting prognosis of HCC. METHODS We retrospectively reviewed 86 patients with HCC (35 female, 51 male) managed in our institution between 2009 and 2014. The expression level of lncRNA NEAT1 was detected by real-time PCR. Prognostic factors were evaluated using Kaplan-Meier curves and Cox proportional hazards models. RESULTS For the entire cohort of 86 patients, we showed that the expression level of NEAT1 was significantly higher in HCC tissues compared with non-tumorous tissues and NEAT1 was increased obviously in the HCC cell lines including SMMC-7721, Huh-7 and Hep3B (P < 0.001). MTT assay showed that si-NEAT1 remarkably inhibited the cell proliferation in three HCC cell lines. Moreover, over-expression of lncRNA NEAT1 was closely related to liver cirrhosis (P = 0.026), microvascular invasion (MVI) (P = 0.023), and TNM stage (P = 0.017). After adjusting for competing risk factors, we identified that expression level of lncRNA NEAT1 was an independently risk factor associated with the prognosis of patients with HCC (P = 0.031). CONCLUSIONS In this study, we found NEAT1 expressed significantly higher in HCC tissues compared with non-tumorous tissues. Overexpression of lncRNA NEAT1 was an independently risk factor associated with the prognosis of patients with HCC.
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Affiliation(s)
- Z Liu
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China
| | - Q Chang
- Yidu Central Hospital of Weifang, Qingzhou, Weifang, Shandong Province, China
| | - F Yang
- Department of Clinic in Lishi Road, General Hospital of Rocket Army, Beijing, China
| | - B Liu
- Center for Disease Prevention and Control of Rocket Force, Beijing, China
| | - H-W Yao
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China
| | - Z-G Bai
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China
| | - C-S Pu
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China
| | - X-M Ma
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China
| | - Y Yang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China
| | - T-T Wang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China
| | - W Guo
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China
| | - X-N Zhou
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China
| | - Z-T Zhang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing, China.
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Zhang D, Liu X, Wei B, Qiao G, Jiang T, Chen Z. Plasma lncRNA GAS8-AS1 as a Potential Biomarker of Papillary Thyroid Carcinoma in Chinese Patients. Int J Endocrinol 2017; 2017:2645904. [PMID: 28781594 PMCID: PMC5525075 DOI: 10.1155/2017/2645904] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/09/2017] [Accepted: 04/24/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Long noncoding RNAs (lncRNAs) were recently shown to have potential in the diagnosis and prognosis for numerous cancers. lncRNA GAS8-AS1 is decreased in papillary thyroid cancer (PTC) tissue, but its plasma expression and clinical value in patients with PTC remain unknown. MATERIALS AND METHODS We investigated the expression profile of plasma GAS8-AS1 in 97 patients with PTC and 39 patients with nodular goiter by quantitative real-time polymerase chain reaction. RESULTS GAS8-AS1 expression in plasma was downregulated in patients with PTC in comparison with those in nodular goiters (P < 0.001). A low level of plasma GAS8-AS1 expression was correlated with lymph node metastasis (LNM) (P < 0.001). Multivariate analysis showed that a reduced GAS8-AS1 level in plasma was associated with LNM (P < 0.05). The area under the receiver operating characteristic curve for GAS8-AS1 was 0.746 in LNM prediction (P < 0.001). CONCLUSION The present study indicates that circulating GAS8-AS1 is a potential biomarker for PTC diagnosis and LNM prediction.
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Affiliation(s)
- Dongxue Zhang
- Department of Endocrinology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - Xin Liu
- Department of Medical Genetics and Developmental Biology, Capital Medical University, Beijing 100069, China
| | - Bojun Wei
- Department of Thyroid and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Guoliang Qiao
- Department of Medical Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing 10038, China
| | - Tao Jiang
- Department of Endocrinology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
- *Tao Jiang: and
| | - Zhenwen Chen
- Department of Medical Genetics and Developmental Biology, Capital Medical University, Beijing 100069, China
- *Zhenwen Chen:
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Schmid M, Trinh QD, Graefen M, Fisch M, Chun FK, Hansen J. The role of biomarkers in the assessment of prostate cancer risk prior to prostate biopsy: which markers matter and how should they be used? World J Urol 2014; 32:871-80. [PMID: 24825472 DOI: 10.1007/s00345-014-1317-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 05/02/2014] [Indexed: 12/12/2022] Open
Abstract
Prostate cancer (PCa) screening has been substantially influenced by the clinical implementation of serum prostate-specific antigen (PSA). In this context, improvement of early PCa detection and stage migration as well as reduced PCa mortality were achieved, and up-to-date PSA represents the gold standard biomarker of PCa diagnosis together with clinical findings. Nonetheless, PSA shows weakness in discriminating between malign and benign prostatic disease or indolent and aggressive cancers. As a result, the expansion of PSA screening is extensively debated with regard to overdetection and ultimately overtreatment, keeping in mind that PCa is still the third leading cause of cancer-specific mortality in the Western male population. Consequently, today's task is to increase the accuracy of PCa detection and furthermore to allow stratification for indolent PCa that might permit active surveillance and to filter out aggressive cancers necessitating treatment. Thus, novel biomarkers, especially in combination with approved clinical risk factors (e.g., age or family history of PCa), within multivariable prediction models carry the potential to improve many aspects of PCa diagnosis and to enable risk classification in clinical practice. Multivariable models lead to superior accuracy for PCa prediction instead of the use of a single risk factor. The aim of this article was to present an overview of known risk factors for PCa together with new promising blood- and urine-based biomarkers and their application within risk models that may allow risk stratification for PCa prior to prostate biopsy. Risk models may optimize PCa detection and classification with regard to improved PCa risk assessment and avoidance of unnecessary prostate biopsies.
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Affiliation(s)
- Marianne Schmid
- Department of Urology, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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