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Artificial Intelligence for Clinical Diagnosis and Treatment of Prostate Cancer. Cancers (Basel) 2022; 14:cancers14225595. [PMID: 36428686 PMCID: PMC9688370 DOI: 10.3390/cancers14225595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/29/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022] Open
Abstract
As medical science and technology progress towards the era of "big data", a multi-dimensional dataset pertaining to medical diagnosis and treatment is becoming accessible for mathematical modelling. However, these datasets are frequently inconsistent, noisy, and often characterized by a significant degree of redundancy. Thus, extensive data processing is widely advised to clean the dataset before feeding it into the mathematical model. In this context, Artificial intelligence (AI) techniques, including machine learning (ML) and deep learning (DL) algorithms based on artificial neural networks (ANNs) and their types, are being used to produce a precise and cross-sectional illustration of clinical data. For prostate cancer patients, datasets derived from the prostate-specific antigen (PSA), MRI-guided biopsies, genetic biomarkers, and the Gleason grading are primarily used for diagnosis, risk stratification, and patient monitoring. However, recording diagnoses and further stratifying risks based on such diagnostic data frequently involves much subjectivity. Thus, implementing an AI algorithm on a PC's diagnostic data can reduce the subjectivity of the process and assist in decision making. In addition, AI is used to cut down the processing time and help with early detection, which provides a superior outcome in critical cases of prostate cancer. Furthermore, this also facilitates offering the service at a lower cost by reducing the amount of human labor. Herein, the prime objective of this review is to provide a deep analysis encompassing the existing AI algorithms that are being deployed in the field of prostate cancer (PC) for diagnosis and treatment. Based on the available literature, AI-powered technology has the potential for extensive growth and penetration in PC diagnosis and treatment to ease and expedite the existing medical process.
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Einoch-Amor R, Broza YY, Haick H. Detection of Single Cancer Cells in Blood with Artificially Intelligent Nanoarray. ACS NANO 2021; 15:7744-7755. [PMID: 33787212 DOI: 10.1021/acsnano.1c01741] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Detection and monitoring of single cancer cells (SCCs), such as circulating tumor cells (CTCs), would be of aid in an efficient early detection of cancer, a tailored (personalized) therapy, and in a fast bedside assessment of treatment efficacy. Nevertheless, currently available techniques, which mostly rely on the isolation of SCCs based on their physical or biological properties, suffer from low sensitivity, complicated technical procedures, low cost-effectiveness, and being unsuitable for continuous monitoring. We report here on the design and use of an artificially intelligent nanoarray based on a heterogeneous set of chemisensitive nanostructured films for the detection of SCCs using volatile organic compounds emanating in the air trapped above blood samples containing SCCs. For demonstration purposes, we have focused on samples containing A549 lung cancer cells (hereafter, SCCA549). The nanoarray developed to detect SCCA549 has >90% accuracy, >85% sensitivity, and >95% specificity. Detection works irrespective of the medium and/or the environment. These results were validated by complementary mass spectrometry. The ability to continuously record, store, and preprocess the signals increases the chances that this nanotechnology might also be useful in the early detection of cancer cells in the blood and continuous monitoring of their possible progression.
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Affiliation(s)
- Reef Einoch-Amor
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, 3200003, Haifa, Israel
| | - Yoav Y Broza
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, 3200003, Haifa, Israel
| | - Hossam Haick
- Department of Chemical Engineering and Russell Berrie Nanotechnology Institute, Technion-Israel Institute of Technology, 3200003, Haifa, Israel
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Van Booven DJ, Kuchakulla M, Pai R, Frech FS, Ramasahayam R, Reddy P, Parmar M, Ramasamy R, Arora H. A Systematic Review of Artificial Intelligence in Prostate Cancer. Res Rep Urol 2021; 13:31-39. [PMID: 33520879 PMCID: PMC7837533 DOI: 10.2147/rru.s268596] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 01/11/2021] [Indexed: 12/12/2022] Open
Abstract
The diagnosis and management of prostate cancer involves the interpretation of data from multiple modalities to aid in decision making. Tools like PSA levels, MRI guided biopsies, genomic biomarkers, and Gleason grading are used to diagnose, risk stratify, and then monitor patients during respective follow-ups. Nevertheless, diagnosis tracking and subsequent risk stratification often lend itself to significant subjectivity. Artificial intelligence (AI) can allow clinicians to recognize difficult relationships and manage enormous data sets, which is a task that is both extraordinarily difficult and time consuming for humans. By using AI algorithms and reducing the level of subjectivity, it is possible to use fewer resources while improving the overall efficiency and accuracy in prostate cancer diagnosis and management. Thus, this systematic review focuses on analyzing advancements in AI-based artificial neural networks (ANN) and their current role in prostate cancer diagnosis and management.
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Affiliation(s)
- Derek J Van Booven
- John P Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Manish Kuchakulla
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Raghav Pai
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Fabio S Frech
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Reshna Ramasahayam
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Pritika Reddy
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Madhumita Parmar
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ranjith Ramasamy
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA.,The Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Himanshu Arora
- John P Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, FL, USA.,Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA.,The Interdisciplinary Stem Cell Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
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Fabrication of electrochemical immunosensor based on acid-substituted poly(pyrrole) polymer modified disposable ITO electrode for sensitive detection of CCR4 cancer biomarker in human serum. Talanta 2021; 222:121487. [DOI: 10.1016/j.talanta.2020.121487] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 07/20/2020] [Accepted: 07/29/2020] [Indexed: 02/07/2023]
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Aladwani M, Lophatananon A, Ollier W, Muir K. Prediction models for prostate cancer to be used in the primary care setting: a systematic review. BMJ Open 2020; 10:e034661. [PMID: 32690501 PMCID: PMC7371149 DOI: 10.1136/bmjopen-2019-034661] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To identify risk prediction models for prostate cancer (PCa) that can be used in the primary care and community health settings. DESIGN Systematic review. DATA SOURCES MEDLINE and Embase databases combined from inception and up to the end of January 2019. ELIGIBILITY Studies were included based on satisfying all the following criteria: (i) presenting an evaluation of PCa risk at initial biopsy in patients with no history of PCa, (ii) studies not incorporating an invasive clinical assessment or expensive biomarker/genetic tests, (iii) inclusion of at least two variables with prostate-specific antigen (PSA) being one of them, and (iv) studies reporting a measure of predictive performance. The quality of the studies and risk of bias was assessed by using the Prediction model Risk Of Bias ASsessment Tool (PROBAST). DATA EXTRACTION AND SYNTHESIS Relevant information extracted for each model included: the year of publication, source of data, type of model, number of patients, country, age, PSA range, mean/median PSA, other variables included in the model, number of biopsy cores to assess outcomes, study endpoint(s), cancer detection, model validation and model performance. RESULTS An initial search yielded 109 potential studies, of which five met the set criteria. Four studies were cohort-based and one was a case-control study. PCa detection rate was between 20.6% and 55.8%. Area under the curve (AUC) was reported in four studies and ranged from 0.65 to 0.75. All models showed significant improvement in predicting PCa compared with being based on PSA alone. The difference in AUC between extended models and PSA alone was between 0.06 and 0.21. CONCLUSION Only a few PCa risk prediction models have the potential to be readily used in the primary healthcare or community health setting. Further studies are needed to investigate other potential variables that could be integrated into models to improve their clinical utility for PCa testing in a community setting.
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Affiliation(s)
- Mohammad Aladwani
- Division of Population Health, Health Services Research and Primary Care School of Health Sciences Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care School of Health Sciences Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - William Ollier
- Division of Population Health, Health Services Research and Primary Care School of Health Sciences Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- School of Healthcare Science, Manchester Metropolitan University Faculty of Science and Engineering, Manchester, UK
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care School of Health Sciences Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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A chemiluminescent dual-aptasensor capable of simultaneously quantifying prostate specific antigen and vascular endothelial growth factor. Anal Biochem 2018; 564-565:102-107. [PMID: 30367880 DOI: 10.1016/j.ab.2018.10.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 10/22/2018] [Accepted: 10/22/2018] [Indexed: 01/10/2023]
Abstract
An aptasensor with guanine chemiluminescence detection was developed for the early diagnosis of prostate cancer with the simultaneous quantifications of prostate specific antigen (PSA) and vascular endothelial growth factor (VEGF). A PSA DNA aptamer conjugated with Texas Red emits red light in guanine chemiluminescence reaction, whereas a VEGF DNA aptamer conjugated with 6-FAM emits green light. The PSA and VEGF aptamers immobilized on the surface of paramagnetic beads mixed with a sample were incubated for 30 min. After the incubation, PSA and VEGF bound with PSA and VEGF aptamers were simultaneously quantified for 20 s using guanine chemiluminescence detections operated with two photomultiplier tubes and two optical filters capable of selectively collecting green or red light. With the increase of PSA concentration, the strength of the red light emitted from Texas Red dropped exponentially, whereas with the increase of VEGF concentration, the green light emitted from 6-FAM was enhanced. The limits of detection were as low as 0.6 ng/ml for PSA and 0.4 ng/ml for VEGF. We confirmed that the dual-aptasensor can be applied as an advanced and new medical device capable of simultaneously quantifying PSA and VEGF to early diagnose prostate cancer with good accuracy, precision, and reproducibility.
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Crulhas BP, Karpik AE, Delella FK, Castro GR, Pedrosa VA. Electrochemical aptamer-based biosensor developed to monitor PSA and VEGF released by prostate cancer cells. Anal Bioanal Chem 2017; 409:6771-6780. [PMID: 29032455 DOI: 10.1007/s00216-017-0630-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 08/30/2017] [Accepted: 09/07/2017] [Indexed: 11/21/2022]
Abstract
Early prostate cancer (PCa) diagnostic is crucial to enhance patient survival rates; besides, non-invasive platforms have been developed worldwide in order to precisely detect PCa biomarkers. Therefore, the aim of the present study is to develop a new aptamer-based biosensor through the self-assembling of thiolated aptamers for PSA and VEGF on the top of gold electrodes. This biosensor was tested in three prostate cell lines (RWPE-1, LNCaP and PC3). The results evidenced a stable and sensitive sensor presenting wide linear detection ranges (0.08-100 ng/mL for PSA and 0.15 ng-100 ng/mL for VEGF). Therefore, the aptasensor was able to detect the patterns of PSA and VEGF released in vitro by PCa cells, which gave new insights about the prostate cancer protein dynamics. Thus, it could be used as a non-invasive PCa clinical diagnosis instrument in the near future. Graphical Abstract Overview of the experimental design applied to the aptamer-based electrochemical sensor self-assembled on the thiolated hairpin structure. A filter membrane was added on top of working electrode to provide the cell-attachment surface after aptamer incubation, without compromising the aptamer layer. The pore membrane allowed target proteins to pass to the aptamer surface; the MCH backfilling avoided unspecific protein binding to the gold electrode surface.
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Affiliation(s)
- Bruno P Crulhas
- Department of Chemistry and Biochemistry, Institute of Bioscience, UNESP-Botucatu, Distrito de Rubiao Jr, 18618-000 Botucatu, São Paulo, 18618-000, Brazil
| | - Agnieszka E Karpik
- Department of Chemistry and Biochemistry, Institute of Bioscience, UNESP-Botucatu, Distrito de Rubiao Jr, 18618-000 Botucatu, São Paulo, 18618-000, Brazil
| | - Flávia K Delella
- Department of Chemistry and Biochemistry, Institute of Bioscience, UNESP-Botucatu, Distrito de Rubiao Jr, 18618-000 Botucatu, São Paulo, 18618-000, Brazil
| | - Gustavo R Castro
- Department of Chemistry and Biochemistry, Institute of Bioscience, UNESP-Botucatu, Distrito de Rubiao Jr, 18618-000 Botucatu, São Paulo, 18618-000, Brazil
| | - Valber A Pedrosa
- Department of Chemistry and Biochemistry, Institute of Bioscience, UNESP-Botucatu, Distrito de Rubiao Jr, 18618-000 Botucatu, São Paulo, 18618-000, Brazil.
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Liu W, Yin B, Wang X, Yu P, Duan X, Liu C, Wang B, Tao Z. Circulating tumor cells in prostate cancer: Precision diagnosis and therapy. Oncol Lett 2017; 14:1223-1232. [PMID: 28789337 PMCID: PMC5529747 DOI: 10.3892/ol.2017.6332] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 03/09/2017] [Indexed: 12/14/2022] Open
Abstract
The primary cause of tumor-associated mortality in prostate cancer (PCa) remains distant metastasis. The dissemination of tumor cells from the primary tumor to distant sites through the bloodstream cannot be detected early by standard imaging methods. Circulating tumor cells (CTCs) represent an effective prognostic and predictive biomarker, which are able to monitor efficacy of adjuvant therapies, detect early development of metastases, and finally, assess therapeutic responses of advanced disease earlier than traditional diagnostic methods. In addition, since repeated tissue biopsies are invasive, costly and not always feasible, the assessment of tumor characteristics on CTCs, by a peripheral blood sample as a liquid biopsy, represents an attractive opportunity. The implementation of molecular and genomic characterization of CTCs may contribute to improve the treatment selection and thus, to move toward more precise diagnosis and therapy in PCa. The present study summarizes the current advances in CTC enrichment and detection strategies and reviews how CTCs may contribute to significant insights in the metastatic process, as well as how they may be utilized in clinical application in PCa. Although it is proposed that CTCs may offer insights into the prognosis and management of PCa, there are a number of challenges in the study of circulating tumor cells, and their clinical utility remains under investigation.
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Affiliation(s)
- Weiwei Liu
- Department of Laboratory Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Binbin Yin
- Department of Laboratory Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Xuchu Wang
- Department of Laboratory Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Pan Yu
- Department of Laboratory Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Xiuzhi Duan
- Department of Laboratory Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Chunhua Liu
- Department of Laboratory Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Ben Wang
- Department of Laboratory Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
| | - Zhihua Tao
- Department of Laboratory Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, P.R. China
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Fan Z, Zhou S, Garcia C, Fan L, Zhou J. pH-Responsive fluorescent graphene quantum dots for fluorescence-guided cancer surgery and diagnosis. NANOSCALE 2017; 9:4928-4933. [PMID: 28368056 PMCID: PMC5501082 DOI: 10.1039/c7nr00888k] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Cancer remains a major cause of morbidity and mortality around the world. Improved cancer treatment requires enhancement of cancer diagnosis and detection. To achieve this goal, here we report a novel imaging probe, pH-responsive fluorescent graphene quantum dots (pRF-GQDs). pRF-GQDs were prepared by electrolysis of graphite rods in sodium p-toluenesulfonate acetonitrile solution. The resulting pRF-GQDs, which have minimal toxicity, display a sharp fluorescence transition between green and blue at pH 6.8, a pH matching the acidic extracellular microenvironment in solid tumors. We found that this unique fluorescence switch property allows tumors to be distinguished from normal tissues. In addition to fluorescence, pRF-GQDs also exhibit upconversion photoluminescence (UCPL). We demonstrate that the combination of UCPL and fluorescence switch enables detection of solid tumors of different origin at an early developmental stage. Therefore, pRF-GQDs have great potential to be used as a universal probe for fluorescence-guided cancer surgery and cancer diagnosis.
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Affiliation(s)
- Zetan Fan
- Department of Chemistry, Beijing Normal University, Beijing, 100875, China.
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Pan LH, Kuo SH, Lin TY, Lin CW, Fang PY, Yang HW. An electrochemical biosensor to simultaneously detect VEGF and PSA for early prostate cancer diagnosis based on graphene oxide/ssDNA/PLLA nanoparticles. Biosens Bioelectron 2017; 89:598-605. [DOI: 10.1016/j.bios.2016.01.077] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 12/28/2015] [Accepted: 01/28/2016] [Indexed: 01/26/2023]
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The Quantified Level of Circulating Prostate Stem Cell Antigen mRNA relative to GAPDH Level Is a Clinically Significant Indictor for Predicting Biochemical Recurrence in Prostate Cancer Patients after Radical Prostatectomy. BIOMED RESEARCH INTERNATIONAL 2015; 2015:292454. [PMID: 26527100 PMCID: PMC4615861 DOI: 10.1155/2015/292454] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 05/09/2015] [Accepted: 05/13/2015] [Indexed: 02/05/2023]
Abstract
The study quantified the relative absolute PSCA level in relation to the glyceraldehyde 3-phosphate dehydrogenase (GAPDH) level in the peripheral blood of 478 hormone-naive prostate cancer (PC) patients who underwent radical prostatectomy from 2005 to 2012 and evaluated its prognostic significance as a risk factor for predicting biochemical recurrence (BCR), compared to known parameters. Nested real-time polymerase chain reaction (RT-PCR) and gel electrophoresis detected PSCA levels and measured the PSCA/GAPDH ratio. Clinicopathological data from the institutional database were examined to determine the adequate cut-off level to predict postoperative BCR. A total of 110 patients had a positive PSCA result (23.0%) via RT-PCR (mean blood ratio 1.1 ± 0.4). The BCR was significantly higher in the PSCA-positive detection group (p = 0.009). A multivariate model was created to show that a PSCA/GAPDH ratio between 1.0 and 1.5 (HR 12.722), clinical T2c stage (HR 0.104), preoperative PSA (HR 1.225), extraprostatic capsule extension (HR 0.006), lymph node dissection (HR 16.437), and positive resection margin (HR 27.453) were significant predictive factors for BCR (p < 0.05). The study showed successful quantification of PSCA with its significance for BCR-related risk factor; however, further studies are needed to confirm its clinical predictive value.
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Stephan C, Jung K, Ralla B. Current biomarkers for diagnosing of prostate cancer. Future Oncol 2015; 11:2743-55. [DOI: 10.2217/fon.15.203] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Prostate cancer (PCa) is mostly detected by prostate-specific antigen (PSA) as one of the most widely used tumor markers. But PSA is limited with its low specificity. The prostate health index (phi) can improve specificity over percent free and total PSA and correlates with aggressive cancer. The urinary PCA3 also shows its utility to detect PCa but its correlation with aggressiveness and the low sensitivity at high values are limitations. While the detection of alterations of the androgen-regulated TMPRSS2 and ETS transcription factor genes in tissue of ˜50% of all PCa patients was one research milestone, the urinary assay should only be used in combination with PCA3. Both US FDA-approved markers phi and PCA3 perform equally.
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Affiliation(s)
- Carsten Stephan
- Department of Urology, Charité – Universitätsmedizin Berlin, CCM, Charitéplatz 1, D-10117 Berlin, Germany
- Berlin Institute for Urologic Research, Berlin, Germany
| | - Klaus Jung
- Department of Urology, Charité – Universitätsmedizin Berlin, CCM, Charitéplatz 1, D-10117 Berlin, Germany
- Berlin Institute for Urologic Research, Berlin, Germany
| | - Bernhard Ralla
- Department of Urology, Charité – Universitätsmedizin Berlin, CCM, Charitéplatz 1, D-10117 Berlin, Germany
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Alexopoulou DK, Kontos CK, Christodoulou S, Papadopoulos IN, Scorilas A. KLK11 mRNA expression predicts poor disease-free and overall survival in colorectal adenocarcinoma patients. Biomark Med 2015; 8:671-85. [PMID: 25123036 DOI: 10.2217/bmm.13.151] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Dysregulated expression of several KLK family members has been observed in colorectal adenocarcinoma. In the present study, the prognostic value of KLK11 mRNA expression as a molecular tissue biomarker in colorectal adenocarcinoma was examined. MATERIALS & METHODS Using quantitative real-time PCR, KLK11 mRNA expression was studied in 120 cancerous and 41 paired noncancerous colorectal specimens obtained from 120 patients with primary colorectal adenocarcinoma. RESULTS A significant upregulation of KLK11 transcripts in colorectal tumors was observed. KLK11 mRNA expression was associated with the depth of tumor invasion and the histological grade. Furthermore, KLK11 mRNA expression predicted poor disease-free and overall survival, independently of patient gender, age, tumor size, location, histological subtype, grade, venous invasion, lymphatic invasion, TNM stage, radiotherapy and chemotherapy treatment. CONCLUSION KLK11 mRNA expression could be considered as a new molecular prognostic biomarker in colorectal adenocarcinoma, with additional prognostic value in patients with highly invasive tumors and/or positive lymph nodes.
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Affiliation(s)
- Dimitra K Alexopoulou
- Department of Biochemistry & Molecular Biology, University of Athens, Panepistimiopolis, 15701, Athens, Greece
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Yang HW, Lin CW, Hua MY, Liao SS, Chen YT, Chen HC, Weng WH, Chuang CK, Pang ST, Ma CCM. Combined detection of cancer cells and a tumor biomarker using an immunomagnetic sensor for the improvement of prostate-cancer diagnosis. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2014; 26:3662-3666. [PMID: 24648414 DOI: 10.1002/adma.201305842] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 01/07/2014] [Indexed: 06/03/2023]
Affiliation(s)
- Hung-Wei Yang
- Department of Chemical Engineering, National Tsing Hua University, 101, Section 2, Kuang-Fu Road, Hsin-chu, 30013, Taiwan, R.O.C
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Stephan C, Ralla B, Jung K. Prostate-specific antigen and other serum and urine markers in prostate cancer. Biochim Biophys Acta Rev Cancer 2014; 1846:99-112. [PMID: 24727384 DOI: 10.1016/j.bbcan.2014.04.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Revised: 03/24/2014] [Accepted: 04/01/2014] [Indexed: 11/16/2022]
Abstract
Prostate-specific antigen (PSA) is one of the most widely used tumor markers, and strongly correlates with the risk of harboring from prostate cancer (PCa). This risk is visible already several years in advance but PSA has severe limitations for PCa detection with its low specificity and low negative predictive value. There is an urgent need for new biomarkers especially to detect clinically significant and aggressive PCa. From all PSA-based markers, the FDA-approved Prostate Health Index (phi) shows improved specificity over percent free and total PSA. Other serum kallikreins or sarcosine in serum or urine show more diverging data. In urine, the FDA-approved prostate cancer gene 3 (PCA3) has also proven its utility in the detection and management of early PCa. However, some aspects on its correlation with aggressiveness and the low sensitivity at very high values have to be re-examined. The detection of a fusion of the androgen regulated TMPRSS2 gene with the ERG oncogene (from the ETS family), which acts as transcription factor gene, in tissue of ~50% of all PCa patients was one milestone in PCa research. When combining the urinary assays for TMPRSS2:ERG and PCA3, an improved accuracy for PCa detection is visible. PCA3 and phi as the best available PCa biomarkers show an equal performance in direct comparisons.
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Affiliation(s)
- Carsten Stephan
- Department of Urology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute for Urologic Research, Berlin, Germany.
| | - Bernhard Ralla
- Department of Urology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Klaus Jung
- Department of Urology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Berlin Institute for Urologic Research, Berlin, Germany
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Fully automated prostate segmentation on MRI: comparison with manual segmentation methods and specimen volumes. AJR Am J Roentgenol 2014; 201:W720-9. [PMID: 24147502 DOI: 10.2214/ajr.12.9712] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The objective of our study was to compare calculated prostate volumes derived from tridimensional MR measurements (ellipsoid formula), manual segmentation, and a fully automated segmentation system as validated by actual prostatectomy specimens. MATERIALS AND METHODS Ninety-eight consecutive patients (median age, 60.6 years; median prostate-specific antigen [PSA] value, 6.85 ng/mL) underwent triplane T2-weighted MRI on a 3-T magnet with an endorectal coil while undergoing diagnostic workup for prostate cancer. Prostate volume estimates were determined using the formula for ellipsoid volume based on tridimensional measurements, manual segmentation of triplane MRI, and automated segmentation based on normalized gradient fields cross-correlation and graph-search refinement. Estimates of prostate volume based on ellipsoid volume, manual segmentation, and automated segmentation were compared with prostatectomy specimen volumes. Prostate volume estimates were compared using the Pearson correlation coefficient and linear regression analysis. The Dice similarity coefficient was used to quantify spatial agreement between manual segmentation and automated segmentation. RESULTS The Pearson correlation coefficient revealed strong positive correlation between prostatectomy specimen volume and prostate volume estimates derived from manual segmentation (R = 0.89-0.91, p < 0.0001) and automated segmentation (R = 0.88-0.91, p < 0.0001). No difference was observed between manual segmentation and automated segmentation. Mean partial and full Dice similarity coefficients of 0.92 and 0.89, respectively, were achieved for axial automated segmentation. CONCLUSION Prostate volume estimates obtained with a fully automated 3D segmentation tool based on normalized gradient fields cross-correlation and graph-search refinement can yield highly accurate prostate volume estimates in a clinically relevant time of 10 seconds. This tool will assist in developing a broad range of applications including routine prostate volume estimations, image registration, biopsy guidance, and decision support systems.
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Simultaneous and combined detection of multiple tumor biomarkers for prostate cancer in human serum by suspension array technology. Biosens Bioelectron 2013; 47:92-8. [DOI: 10.1016/j.bios.2013.02.052] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 02/17/2013] [Accepted: 02/18/2013] [Indexed: 12/13/2022]
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18
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Kalhor H, Ameli A, Alizadeh N. Electrochemically controlled solid-phase micro-extraction of proline using a nanostructured film of polypyrrole, and its determination by ion mobility spectrometry. Mikrochim Acta 2013. [DOI: 10.1007/s00604-013-0984-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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19
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Kontos CK, Chantzis D, Papadopoulos IN, Scorilas A. Kallikrein-related peptidase 4 (KLK4) mRNA predicts short-term relapse in colorectal adenocarcinoma patients. Cancer Lett 2012. [PMID: 23201139 DOI: 10.1016/j.canlet.2012.11.036] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The members of the kallikrein-related peptidase (KLK) family are aberrantly expressed in cancer, including colorectal adenocarcinoma. KLK4 is an endogenous activator of protease-activated receptor 1 (PAR1) in HT-29 colorectal adenocarcinoma cells, inducing PAR1 signaling and subsequent ERK1/2 activation. The aim of this study was to analyze KLK4 mRNA expression in colorectal adenocarcinoma and to examine its prognostic value as a novel molecular tissue biomarker in this malignancy. Therefore, total RNA was isolated from primary tumors of 81 colorectal adenocarcinoma patients, cDNA was prepared, and KLK4 mRNA expression analysis was performed using quantitative real-time PCR. KLK4 mRNA was significantly associated with the Dukes stage, tumor invasion, size, and histological grade. Survival analysis demonstrated that KLK4 mRNA expression constitutes an unfavorable prognostic biomarker in colorectal adenocarcinoma, predicting poor disease-free survival (DFS), independently of the nodal status and tumor size. Furthermore, KLK4 mRNA predicts short-term relapse of lymph node-negative patients or those with tumors of early Dukes stage. In conclusion, KLK4 mRNA expression can be regarded as a novel potential tissue biomarker in colorectal adenocarcinoma.
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Affiliation(s)
- Christos K Kontos
- Department of Biochemistry and Molecular Biology, University of Athens, Athens, Greece
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Ecke TH, Hallmann S, Koch S, Ruttloff J, Cammann H, Gerullis H, Miller K, Stephan C. External validation of an artificial neural network and two nomograms for prostate cancer detection. ISRN UROLOGY 2012; 2012:643181. [PMID: 22830050 PMCID: PMC3399415 DOI: 10.5402/2012/643181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 05/13/2012] [Indexed: 11/23/2022]
Abstract
Background. Multivariate models are used to increase prostate cancer (PCa) detection rate and to reduce unnecessary biopsies. An external validation of the artificial neural network (ANN) "ProstataClass" (ANN-Charité) was performed with daily routine data. Materials and Methods. The individual ANN predictions were generated with the use of the ANN application for PSA and free PSA assays, which rely on age, tPSA, %fPSA, prostate volume, and DRE (ANN-Charité). Diagnostic validity of tPSA, %fPSA, and the ANN was evaluated by ROC curve analysis and comparisons of observed versus predicted probabilities. Results. Overall, 101 (35.8%) PCa were detected. The areas under the ROC curve (AUCs) were 0.501 for tPSA, 0.669 for %fPSA, 0.694 for ANN-Charité, 0.713 for nomogram I, and 0.742 for nomogram II, showing a significant advantage for nomogram II (P = 0.009) compared with %fPSA while the other model did not differ from %fPSA (P = 0.15 and P = 0.41). All models overestimated the predicted PCa probability. Conclusions. Beside ROC analysis, calibration is an important tool to determine the true value of using a model in clinical practice. The worth of multivariate models is limited when external validations were performed without knowledge of the circumstances of the model's development.
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Affiliation(s)
- Thorsten H. Ecke
- Department of Urology, HELIOS Hospital, 15526 Bad Saarow, Germany
| | - Steffen Hallmann
- Department of Urology, HELIOS Hospital, 15526 Bad Saarow, Germany
| | - Stefan Koch
- Institute of Pathology, HELIOS Hospital, Bad Saarow, Germany
| | - Jürgen Ruttloff
- Department of Urology, HELIOS Hospital, 15526 Bad Saarow, Germany
| | - Henning Cammann
- Institute of Medical Informatics, Charité—Universitätsmedizin Berlin, 10098 Berlin, Germany
| | | | - Kurt Miller
- Department of Urology, Charité—Universitätsmedizin Berlin, 10098 Berlin, Germany
| | - Carsten Stephan
- Department of Urology, Charité—Universitätsmedizin Berlin, 10098 Berlin, Germany
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Bulman JC, Toth R, Patel AD, Bloch BN, McMahon CJ, Ngo L, Madabhushi A, Rofsky NM. Automated computer-derived prostate volumes from MR imaging data: comparison with radiologist-derived MR imaging and pathologic specimen volumes. Radiology 2012; 262:144-51. [PMID: 22190657 DOI: 10.1148/radiol.11110266] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To compare prostate gland volume (PV) estimation of automated computer-generated multifeature active shape models (MFAs) performed with 3-T magnetic resonance (MR) imaging with that of other methods of PV assessment, with pathologic specimens as the reference standard. MATERIALS AND METHODS All subjects provided written informed consent for this HIPAA-compliant and institutional review board-approved study. Freshly weighed prostatectomy specimens from 91 patients (mean age, 59 years; range, 42-84 years) served as the reference standard. PVs were manually calculated by two independent readers from MR images by using the standard ellipsoid formula. Planimetry PV was calculated from gland areas generated by two independent investigators by using manually drawn regions of interest. Computer-automated assessment of PV with an MFA was determined by the aggregate computer-calculated prostate area over the range of axial T2-weighted prostate MR images. Linear regression, linear mixed-effects models, concordance correlation coefficients, and Bland-Altman limits of agreement were used to compare volume estimation methods. RESULTS MFA-derived PVs had the best correlation with pathologic specimen PVs (slope, 0.888). Planimetry derived volumes produced slopes of 0.864 and 0.804 for two independent readers when compared with specimen PVs. Ellipsoid formula-derived PVs had slopes closest to one when compared with planimetry PVs. Manual MR imaging and MFA PV estimates had high concordance correlation coefficients with pathologic specimens. CONCLUSION MFAs with axial T2-weighted MR imaging provided an automated and efficient tool with which to assess PV. Both MFAs and MR imaging planimetry require adjustments for optimized PV accuracy when compared with prostatectomy specimens.
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Affiliation(s)
- Julie C Bulman
- Georgetown University School of Medicine, Washington, DC, USA
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Guo C, Linton A, Kephart S, Ornelas M, Pairish M, Gonzalez J, Greasley S, Nagata A, Burke BJ, Edwards M, Hosea N, Kang P, Hu W, Engebretsen J, Briere D, Shi M, Gukasyan H, Richardson P, Dack K, Underwood T, Johnson P, Morell A, Felstead R, Kuruma H, Matsimoto H, Zoubeidi A, Gleave M, Los G, Fanjul AN. Discovery of Aryloxy Tetramethylcyclobutanes as Novel Androgen Receptor Antagonists. J Med Chem 2011; 54:7693-704. [DOI: 10.1021/jm201059s] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Kevin Dack
- World-Wide Medicinal Chemistry, Pfizer Worldwide Research & Development, Sandwich, CT 13 9NJ, United Kingdom
| | - Toby Underwood
- World-Wide Medicinal Chemistry, Pfizer Worldwide Research & Development, Sandwich, CT 13 9NJ, United Kingdom
| | - Patrick Johnson
- World-Wide Medicinal Chemistry, Pfizer Worldwide Research & Development, Sandwich, CT 13 9NJ, United Kingdom
| | - Andrew Morell
- World-Wide Medicinal Chemistry, Pfizer Worldwide Research & Development, Sandwich, CT 13 9NJ, United Kingdom
| | - Robert Felstead
- World-Wide Medicinal Chemistry, Pfizer Worldwide Research & Development, Sandwich, CT 13 9NJ, United Kingdom
| | - Hidetoshi Kuruma
- The Vancouver Prostate Centre, University of British Columbia, 2660 Oak Street, Vancouver BC, V6H 3Z6, Canada
| | - Hiroaki Matsimoto
- The Vancouver Prostate Centre, University of British Columbia, 2660 Oak Street, Vancouver BC, V6H 3Z6, Canada
| | - Amina Zoubeidi
- The Vancouver Prostate Centre, University of British Columbia, 2660 Oak Street, Vancouver BC, V6H 3Z6, Canada
| | - Martin Gleave
- The Vancouver Prostate Centre, University of British Columbia, 2660 Oak Street, Vancouver BC, V6H 3Z6, Canada
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Kannan R, Zambre A, Chanda N, Kulkarni R, Shukla R, Katti K, Upendran A, Cutler C, Boote E, Katti KV. Functionalized radioactive gold nanoparticles in tumor therapy. WILEY INTERDISCIPLINARY REVIEWS-NANOMEDICINE AND NANOBIOTECHNOLOGY 2011; 4:42-51. [PMID: 21953803 DOI: 10.1002/wnan.161] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The development of new treatment modalities that offer clinicians the ability to reduce sizes of tumor prior to surgical resection or to achieve complete ablation without surgery would be a significant medical breakthrough in the overall care and treatment of prostate cancer patients. The goal of our investigation is aimed at validating the hypothesis that Gum Arabic-functionalized radioactive gold nanoparticles (GA-(198) AuNP) have high affinity toward tumor vasculature. We hypothesized further that intratumoral delivery of the GA-(198) AuNP agent within prostate tumor will allow optimal therapeutic payload that will significantly or completely ablate tumor without side effects, in patients with hormone refractory prostate cancer. In order to evaluate the therapeutic efficacy of this new nanoceutical, GA-(198) AuNP was produced by stabilization of radioactive gold nanoparticles ((198) Au) with the FDA-approved glycoprotein, GA. This review will describe basic and clinical translation studies toward realization of the therapeutic potential and myriad of clinical applications of GA-(198) AuNP agent in treating prostate and various solid tumors in human cancer patients.
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Guo H, Gallazzi F, Sklar LA, Miao Y. A novel indium-111-labeled gonadotropin-releasing hormone peptide for human prostate cancer imaging. Bioorg Med Chem Lett 2011; 21:5184-7. [PMID: 21821417 DOI: 10.1016/j.bmcl.2011.07.055] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Revised: 07/12/2011] [Accepted: 07/13/2011] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to evaluate the tumor targeting and imaging properties of a novel (111)In-labeled gonadotropin-releasing hormone (GnRH) peptide {1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-Ahx-(D-Lys(6)-GnRH1)} for human prostate cancer. The biodistribution and tumor imaging properties of (111)In-DOTA-Ahx-(D-Lys(6)-GnRH1) were determined in DU145 human prostate cancer-xenografted nude mice. (111)In-DOTA-Ahx-(d-Lys(6)-GnRH1) exhibited rapid tumor uptake (1.27 ± 0.40% ID/g at 0.5h post-injection) coupled with fast whole-body clearance through the urinary system. The DU145 human prostate cancer-xenografted tumor lesions were clearly visualized by single photon emission computed tomography (SPECT)/CT at 0.5h post-injection of (111)In-DOTA-Ahx-(D-Lys(6)-GnRH1). The successful imaging of DU145 human prostate cancer-xenografted tumor lesions using (111)In-DOTA-Ahx-(d-Lys(6)-GnRH1) highlighted its potential as a novel imaging probe for human prostate cancer imaging.
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Affiliation(s)
- Haixun Guo
- College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
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25
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Stephan C, Siemssen K, Cammann H, Friedersdorff F, Deger S, Schrader M, Miller K, Lein M, Jung K, Meyer HA. Between-method differences in prostate-specific antigen assays affect prostate cancer risk prediction by nomograms. Clin Chem 2011; 57:995-1004. [PMID: 21610217 DOI: 10.1373/clinchem.2010.151472] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND To date, no published nomogram for prostate cancer (PCa) risk prediction has considered the between-method differences associated with estimating concentrations of prostate-specific antigen (PSA). METHODS Total PSA (tPSA) and free PSA were measured in 780 biopsy-referred men with 5 different assays. These data, together with other clinical parameters, were applied to 5 published nomograms that are used for PCa detection. Discrimination and calibration criteria were used to characterize the accuracy of the nomogram models under these conditions. RESULTS PCa was found in 455 men (58.3%), and 325 men had no evidence of malignancy. Median tPSA concentrations ranged from 5.5 μg/L to 7.04 μg/L, whereas the median percentage of free PSA ranged from 10.6% to 16.4%. Both the calibration and discrimination of the nomograms varied significantly across different types of PSA assays. Median PCa probabilities, which indicate PCa risk, ranged from 0.59 to 0.76 when different PSA assays were used within the same nomogram. On the other hand, various nomograms produced different PCa probabilities when the same PSA assay was used. Although the ROC curves had comparable areas under the ROC curve, considerable differences were observed among the 5 assays when the sensitivities and specificities at various PCa probability cutoffs were analyzed. CONCLUSIONS The accuracy of the PCa probabilities predicted according to different nomograms is limited by the lack of agreement between the different PSA assays. This difference between methods may lead to unacceptable variation in PCa risk prediction. A more cautious application of nomograms is recommended.
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Affiliation(s)
- Carsten Stephan
- Department of Urology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
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26
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Khonyoung S, Reanpang P, Kongtawelert P, Pencharee S, Jakmunee J, Grudpan K, Hartwell SK. Sequential Injection System with Modified Glass Capillary for Automation in Immunoassay of Chondroitin Sulfate. ANAL LETT 2011. [DOI: 10.1080/00032719.2010.500776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bartosch-Härlid A, Andersson R. Diabetes mellitus in pancreatic cancer and the need for diagnosis of asymptomatic disease. Pancreatology 2010; 10:423-8. [PMID: 20720443 DOI: 10.1159/000264676] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Pancreatic cancer is strongly associated with the development of hyperglycemia, peripheral insulin resistance and diabetes mellitus, especially when presented as new-onset diabetes mellitus. Peripheral insulin resistance and hyperinsulinemia have been suggested to promote growth of pancreatic cancer cells, and therefore a relation between long-standing diabetes mellitus type 2 and pancreatic cancer has been implied. Epidemiological studies, though, give incongruent results to this problem. There are data supporting a tumor-derived influence on glucose metabolism, insulin secretion and eventually the development of diabetes mellitus in early stages of pancreatic cancer. The only possibility for curative intent in pancreatic cancer is to diagnose the disease before symptoms occur. Patients with newly diagnosed diabetes mellitus type 2 or hyperglycemia as a risk group have been recommended for primary screening for pancreatic cancer. To date, there is no specific biomarker to identify patients with an asymptomatic pancreatic cancer. The review discuss the relationship between pancreatic cancer and diabetes mellitus and the possibility of secondary screening of patients with newly diagnosed diabetes mellitus type 2 or hyperglycemia in an artificial neural network. PubMed was searched for articles using the Mesh term 'pancreatic neoplasms' combined with 'insulin resistance' and 'glucose metabolism disorders'. Additional articles were retrieved through hyperlinks and by manually searching reference lists in original published articles. In total 36 articles were systematically reviewed. and IAP.
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Sokoll LJ, Sanda MG, Feng Z, Kagan J, Mizrahi IA, Broyles DL, Partin AW, Srivastava S, Thompson IM, Wei JT, Zhang Z, Chan DW. A prospective, multicenter, National Cancer Institute Early Detection Research Network study of [-2]proPSA: improving prostate cancer detection and correlating with cancer aggressiveness. Cancer Epidemiol Biomarkers Prev 2010; 19:1193-200. [PMID: 20447916 PMCID: PMC2867076 DOI: 10.1158/1055-9965.epi-10-0007] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The free prostate-specific antigen (PSA) isoform, [-2]proPSA, has been shown to be associated with prostate cancer. The study objective was to characterize the clinical utility of serum [-2]proPSA for prostate cancer detection and assess its association with aggressive disease. METHODS From among 669 subjects in a prospective prostate cancer detection study at four National Cancer Institute Early Detection Research Network clinical validation centers, 566 were eligible. Serum PSA, free PSA, and [-2]proPSA were measured (Beckman Coulter Access 2 Analyzer). RESULTS Two hundred and forty-five (43%) of the 566 participants had prostate cancer on biopsy. At 70% specificity, the sensitivity of %[-2]proPSA ([-2]proPSA/fPSA) was 54% [95% confidence interval (CI), 48-61%; null hypothesis, 40%]. Including %[-2]proPSA in a multivariate prediction model incorporating PSA and %fPSA improved the performance (P<0.01). In the 2 to 4 ng/mL PSA range, %[-2]proPSA outperformed %fPSA (receiver operator characteristic-areas under the curve, 0.73 versus 0.61; P=0.01). At 80% sensitivity, %[-2]proPSA had significantly higher specificity (51.6%; 95% CI, 41.2-61.8%) than PSA (29.9%; 95% CI, 21.0-40.0%) and %fPSA (28.9%; 95% CI, 20.1-39.0%). In the 2 to 10 ng/mL PSA range, a multivariate model had significant improvement (area under the curve, 0.76) over individual PSA forms (P<0.01 to <0.0001). At 80% sensitivity, the specificity of %[-2]proPSA (44.9%; 95% CI, 38.4-51.5%) was significantly higher than PSA (30.8%; 95% CI, 24.9-37.1%) and relatively higher than %fPSA (34.6%; 95% CI, 28.5-41.4%). %[-2]proPSA increased with increasing Gleason score (P<0.001) and was higher in aggressive cancers (P=0.03). CONCLUSIONS In this prospective study, %[-2]proPSA showed potential clinical utility for improving prostate cancer detection and was related to the risk of aggressive disease. IMPACT The addition of %[-2]proPSA could affect the early detection of prostate cancer.
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Affiliation(s)
- Lori J Sokoll
- Department of Pathology, Johns Hopkins Medical Institutions, 600 North Wolfe Street, Meyer B-125, Baltimore, MD 21287, USA.
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Ecke TH, Bartel P, Hallmann S, Koch S, Ruttloff J, Cammann H, Lein M, Schrader M, Miller K, Stephan C. Outcome prediction for prostate cancer detection rate with artificial neural network (ANN) in daily routine. Urol Oncol 2010; 30:139-44. [PMID: 20363164 DOI: 10.1016/j.urolonc.2009.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 12/09/2009] [Accepted: 12/11/2009] [Indexed: 10/19/2022]
Abstract
BACKGROUND We evaluated the use of the artificial neural network (ANN) program "ProstataClass" of the Department of Urology and the Institute of Medical Informatics at the Charité-Universitätsmedizin Berlin in daily routine to increase prostate cancer (CaP) detection rate and to reduce unnecessary biopsies. MATERIALS AND METHODS From May 2005 to April 2007, a total of 204 patients were included in the study. The Beckman Access PSA assay was used, and pretreatment prostate specific antigen (PSA) was measured prior to digital rectal examination (DRE) and 12 core systematic transrectal ultrasound (TRUS) guided biopsies. The individual ANN predictions were generated with the use of the ANN application for the Beckman Access PSA and free PSA assays, which relies on age, PSA, percent free prostate specific antigen (%fPSA), prostate volume, and DRE. Diagnostic validity of total prostate specific antigen (tPSA), %fPSA, and the ANN was evaluated by ROC curve analysis. RESULTS PSA and %fPSA ranged from 4.01 to 9.91 ng/ml (median: 6.65) and 5% to 48% (median: 15%), respectively. Of all men, 46 (22.5%) demonstrated suspicious DRE findings. Total prostate volume ranged from 7.1 to 119.2 cc (median: 35). Overall, 71 (34.8%) CaP were detected. Of men with suspicious DRE, 28 (60.9%) had CaP on initial biopsy. The ANN was 78% accurate in the original report. The AUC of ROC curve analysis was 0.51 for PSA, 0.66 for %PSA, and 0.72 for the ANN-Output, respectively. CONCLUSIONS Our results in this independent cohort show that ANN is a very helpful parameter in daily routine to increase the CaP detection rate and reduce unnecessary biopsies.
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Affiliation(s)
- Thorsten H Ecke
- Department of Urology, HELIOS Hospital, Bad Saarow, Germany.
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30
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Chanda N, Kan P, Watkinson LD, Shukla R, Zambre A, Carmack TL, Engelbrecht H, Lever JR, Katti K, Fent GM, Casteel SW, Smith CJ, Miller WH, Jurisson S, Boote E, Robertson JD, Cutler C, Dobrovolskaia M, Kannan R, Katti KV. Radioactive gold nanoparticles in cancer therapy: therapeutic efficacy studies of GA-198AuNP nanoconstruct in prostate tumor–bearing mice. NANOMEDICINE-NANOTECHNOLOGY BIOLOGY AND MEDICINE 2010; 6:201-9. [DOI: 10.1016/j.nano.2009.11.001] [Citation(s) in RCA: 159] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 10/18/2009] [Accepted: 11/03/2009] [Indexed: 11/24/2022]
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Marin OR, Ruiz D, Soriano A, Delgado FJ. Automatic decision using dirty databases: application to prostate cancer diagnosis. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2010; 2010:1162-1165. [PMID: 21095907 DOI: 10.1109/iembs.2010.5626259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Currently, the best way to reduce the mortality of cancer is to detect and treat it in its early stages. Automatic decision support systems, such as automatic diagnosis systems, are very helpful in this task but their performance is constrained by the integrity of the clinical input data. This could be a problem since clinical databases, in which these systems are based on, are commonly built up containing dirty data (empty fields, non-standard or normalized values, etc). This article presents a study of the performance of a clinical decision support system, based on an artificial neural networks, using sets of clean and dirty prostate cancer data. The study shows that is possible to obtain an implementation that allow us to avoid the problems associated to the database's lack of integrity and reach a similar performance using either clean or dirty data.
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Affiliation(s)
- Oscar R Marin
- Bioinspired Engineering and Health Computing Research Group, University of Alicante, P.O. 99 E-03080 Spain.
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Stephan C, Cammann H, Bender M, Miller K, Lein M, Jung K, Meyer HA. Internal validation of an artificial neural network for prostate biopsy outcome. Int J Urol 2009; 17:62-8. [PMID: 19925616 DOI: 10.1111/j.1442-2042.2009.02417.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To carry out an internal validation of the retrospectively trained artificial neural network (ANN) 'ProstataClass'. METHODS A prospectively collected database of 393 patients undergoing 8-12 core prostate biopsy was analyzed. Data of these patients were applied to the online available ANN 'ProstataClass' using the Elecsys total prostate-specific antigen (tPSA) and free PSA (fPSA) assays. Beside the internal validation of the ANN 'ProstataClass' an additional ANN (named as ANN internal validation: ANNiv) only using the 393 prospective patient data was evaluated. The new ANN model was constructed with the MATLAB Neural Network Toolbox. Diagnostic accuracy was evaluated by receiver operator characteristic (ROC) curves comparing the areas under the ROC curves (AUC) and specificities at 90% and 95% sensitivity. RESULTS Within a tPSA range of 1.0-22.8 ng/mL, 229 men (58.3%) had prostate cancer (PCa). tPSA, %fPSA and the number of positive digital rectal examinations (DRE) differed significantly from the cohort of patients of the ANN 'ProstataClass', whereas age and prostate volume were comparable. AUCs for tPSA, %fPSA and the ANN 'ProstataClass' were 0.527, 0.726 and 0.747 (P = 0.085 between %fPSA and ANN). The AUC of the ANNiv (0.754) was significantly better compared with %fPSA (P = 0.021), whereas the AUC of two ANN models built on external cohorts (0.726 and 0.729) showed no differences to %fPSA and the other ANN models. CONCLUSIONS Significant differences of DRE status and %fPSA medians decrease the power of the 'ProstataClass' ANN in the internal validation cohort. The effect of retrospective data evaluation the 'ProstataClass' cohort and prospective fPSA measurement may be responsible for %fPSA differences. All ANN models built with different PSA and fPSA assays performed equally if applied to the two cohorts.
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Affiliation(s)
- Carsten Stephan
- Department of Urology, Charité Universitätsmedizin Berlin, Berlin, Germany.
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Meijer RP, Gemen EFA, van Onna IEW, van der Linden JC, Beerlage HP, Kusters GCM. The value of an artificial neural network in the decision-making for prostate biopsies. World J Urol 2009; 27:593-8. [PMID: 19562346 DOI: 10.1007/s00345-009-0444-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Accepted: 06/15/2009] [Indexed: 11/25/2022] Open
Abstract
PURPOSE In majority of patients who are subjected to prostate biopsies, no prostate cancer (PCa) is found. It is important to prevent unnecessary biopsies since serious complications may occur. An artificial neural network (ANN) may be able to predict the risk of the presence of PCa. METHODS Included were all patients, who underwent transrectal ultrasound-guided prostate biopsies between June 2006 and June 2007 with a total PSA (tPSA) level between 2 and 20 microg/l. The patients were divided into two groups according to their tPSA level (2-10 microg/l and 10-20 microg/l). The ANN Prostataclass of the Universitätsklinikum Charité in Berlin was used. The predictions of the ANN were compared to the pathology results of the biopsies. RESULTS Overall 165 patients were included. PCa was diagnosed in 53 patients, whereas the ANN predicted "no risk" in 19 of these patients (36%). The ANN output receiver operator characteristic (ROC) plots for the range of tPSA 2-10 microg/l and tPSA 10-20 microg/l showed an area under the curve (AUC) of 63 and 88% for the initial biopsy group, versus 69 and 57%, respectively, for the repeat biopsy group. CONCLUSIONS The ANN resulted in a false negative rate of 36%, missing PCa in 19 patients. For use in an outpatient-clinical setting, this ANN is insufficient to predict the risk of presence of PCa reliably.
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Affiliation(s)
- R P Meijer
- Department of Urology, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, The Netherlands.
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Stephan C, Kahrs AM, Cammann H, Lein M, Schrader M, Deger S, Miller K, Jung K. A [-2]proPSA-based artificial neural network significantly improves differentiation between prostate cancer and benign prostatic diseases. Prostate 2009; 69:198-207. [PMID: 18942119 DOI: 10.1002/pros.20872] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The aim of this study was to combine the new automated Access [-2]proPSA (p2PSA) assay with a percent free PSA (%fPSA) based artificial neural network (ANN) or logistic regression (LR) model to enhance discrimination between patients with prostate cancer (PCa) and with no evidence of malignancy (NEM) and to detect aggressive PCa. METHODS Sera from 311 PCa patients and 275 NEM patients were measured with the p2PSA, total PSA (tPSA) and free PSA (fPSA) assays on Access immunoassay technology (Beckman Coulter, Fullerton, CA) within the 0-30 ng/ml tPSA range. Four hundred seventy-five patients (264 PCa, 211 NEM) had a tPSA of 2-10 ng/ml. LR models and leave-one-out (LOO) ANN models with Bayesian regularization by using tPSA, %fPSA, p2PSA/fPSA (%p2PSA), age and prostate volume were constructed and compared by receiver-operating characteristic (ROC) curve analysis. RESULTS The ANN and LR model each utilizing %p2PSA, %fPSA, tPSA and age, but without prostate volume, reached the highest AUCs (0.85 and 0.84) and best specificities (ANN: 62.1% and 45.5%; LR: 53.1% and 41.2%) compared with tPSA (22.7% and 11.4%) and %fPSA (45.5% and 26.1%) at 90% and 95% sensitivity. The %p2PSA furthermore distinguished better than tPSA and %fPSA between pT2 and pT3, and Gleason sum <7 and >or=7 PCa. CONCLUSIONS The automated p2PSA assay offers a new tool to improve PCa detection, and especially aggressive PCa detection. Incorporation of %p2PSA into an ANN and LR model further enhances the diagnostic accuracy to differentiate between malignant and non-malignant prostate diseases.
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Affiliation(s)
- Carsten Stephan
- Department of Urology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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Diagnostic strategies and the incidence of prostate cancer: reasons for the low reported incidence of prostate cancer in China. Asian J Androl 2008; 11:9-13. [PMID: 19050685 DOI: 10.1038/aja.2008.21] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
We have analysed the reasons for the low reported incidence of prostate cancer in China and argue for early diagnosis and treatment of this disease. According to the 2002 database of the International Agency for Research on Cancer (IARC), the age-standardized incidence of prostate cancer in China is 1.6/10(5) person years (PY), with a mortality rate of 1.0/10(5) PY and mortality-to-incidence rate ratio (MR/IR) = 0.63. The MR/IR ratio of prostate cancer in China was found to be higher than the average in Asia (MR/IR = 0.57) and much higher than that in North America (MR/IR = 0.13). These data indicate that in China most prostate cancers were in the advanced stages at the time of diagnosis, and that patients had a short survival time thereafter. In 2004, Stamey et al. reported a retrospective American study of prostate cancer for the years 1983-2003. It was shown that most cases of prostate cancer detected by prostate-specific antigen (PSA) screening were in the advanced stage at the start of this 20-year period. These early follow-up data are quite similar to the results obtained from mass PSA screening of elderly men in Changchun, China. However, after the American programmes for early diagnosis and treatment of prostate cancer were accepted, tumours were diagnosed at earlier stages. On the basis of these findings, mass screening should be performed in the whole of China using serum PSA to facilitate early diagnosis and treatment of prostate cancer.
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Stephan C, Jung K, Lein M. Editorial Comment. J Urol 2008. [DOI: 10.1016/j.juro.2008.04.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Carsten Stephan
- Department of Urology, Charité - Universitätsmedizin Berlin and Berlin Institute for Urological Research, Berlin, Germany
| | - Klaus Jung
- Department of Urology, Charité - Universitätsmedizin Berlin and Berlin Institute for Urological Research, Berlin, Germany
| | - Michael Lein
- Department of Urology, Charité - Universitätsmedizin Berlin and Berlin Institute for Urological Research, Berlin, Germany
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Stephan C, Cammann H, Meyer HA, Müller C, Deger S, Lein M, Jung K. An artificial neural network for five different assay systems of prostate-specific antigen in prostate cancer diagnostics. BJU Int 2008; 102:799-805. [PMID: 18522632 DOI: 10.1111/j.1464-410x.2008.07765.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To compare separate prostate-specific antigen (PSA) assay-specific artificial neural networks (ANN) for discrimination between patients with prostate cancer (PCa) and no evidence of malignancy (NEM). PATIENTS AND METHODS In 780 patients (455 with PCa, 325 with NEM) we measured total PSA (tPSA) and free PSA (fPSA) with five different assays: from Abbott (AxSYM), Beckman Coulter (Access), DPC (Immulite 2000), and Roche (Elecsys 2010) and with tPSA and complexed PSA (cPSA) assays from Bayer (ADVIA Centaur). ANN models were developed with five input factors: tPSA, percentage free/total PSA (%fPSA), age, prostate volume and digital rectal examination status for each assay separately to examine two tPSA ranges of 0-10 and 10-27 ng/mL. RESULTS Compared with the median tPSA concentrations (range from 4.9 [Bayer] to 6.11 ng/mL [DPC]) and especially the median %fPSA values (range from 11.2 [DPC] to 17.4%[Abbott], for tPSA 0-10 ng/mL), the areas under the receiver operating characteristic curves (AUC) for all calculated ANN models did not significantly differ from each other. The AUC were: 0.894 (Abbott), 0.89 (Bayer), 0.895 (Beckman), 0.882 (DPC) and 0.892 (Roche). At 95% sensitivity the specificities were without significant differences, whereas the individual absolute ANN outputs differed markedly. CONCLUSIONS Despite only slight differences, PSA assay-specific ANN models should be used to optimize the ANN outcome to reduce the number of unnecessary prostate biopsies. We further developed the ANN named 'ProstataClass' to provide clinicians with an easy to use tool in making their decision about follow-up testing.
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Affiliation(s)
- Carsten Stephan
- Institute for Medical Informatics, Charlité-Universitätsmedzin Berlin, Berlin, Germany.
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Stephan C, Cammann H, Lein M, Miller K, Jung K. Re: Application of Artificial Intelligence to the Management of Urological Cancer. J Urol 2008; 179:2067. [DOI: 10.1016/j.juro.2008.01.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2007] [Indexed: 11/28/2022]
Affiliation(s)
- Carsten Stephan
- Department of Urology and Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, D-10098 Berlin, Germany
| | - Henning Cammann
- Department of Urology and Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, D-10098 Berlin, Germany
| | - Michael Lein
- Department of Urology and Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, D-10098 Berlin, Germany
| | - Kurt Miller
- Department of Urology and Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, D-10098 Berlin, Germany
| | - Klaus Jung
- Department of Urology and Institute of Medical Informatics, Charité-Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, D-10098 Berlin, Germany
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Rauch J, Gires O. SEREX, Proteomex, AMIDA, and beyond: Serological screening technologies for target identification. Proteomics Clin Appl 2008; 2:355-71. [DOI: 10.1002/prca.200780064] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Indexed: 01/08/2023]
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Steuber T, O'Brien MF, Lilja H. Serum markers for prostate cancer: a rational approach to the literature. Eur Urol 2008; 54:31-40. [PMID: 18243505 DOI: 10.1016/j.eururo.2008.01.034] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2007] [Accepted: 01/04/2008] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Due to its universal applicability for early detection and prediction of cancer stage and disease recurrence, widespread implementation of serum-based prostate-specific antigen (PSA) measurements has a significant influence on current treatment strategies for men with prostate cancer (PCa). However, over-detection and the resultant over-treatment of indolent cancers have been strongly implicated to occur. Using current recommended guidelines, the PSA test suffers from both limited sensitivity and specificity to enable efficacious population-based cancer detection. Therefore, novel biomarkers are much needed to complement PSA by enhancing its diagnostic and prognostic performance. METHODS The present literature on serum markers for PCa was reviewed. PSA derivatives, molecular PSA isoforms, and novel molecular targets in blood were summarized and weighted against their potential to improve decision-making of men with PCa. RESULTS Current evidence suggests that no single analyte is likely to achieve the desired level of diagnostic and prognostic accuracy for PCa. However, the combination of biomarkers with clinical and demographic data, for example, using established standard nomograms, has produced progress toward the goal of both optimal screening and risk assessment. Furthermore, potential candidate molecular markers for PCa can be derived from high-throughput technologies. Current studies demonstrate that understanding dynamic PSA changes over time may offer diagnostic and prognostic information. CONCLUSIONS Bridging the gap between basic science and clinical practice represents the main goal in the near future to enable physicians to tailor risk-adjusted screening and treatment strategies for current patients with PCa.
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Affiliation(s)
- Thomas Steuber
- Department of Urology, University Clinic Hamburg Eppendorf, Hamburg, Germany.
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Stephan C, Jung K, Cammann H, Kramer J, Kristiansen G, Loening SA, Lein M. Neue Serummarker des Prostatakarzinoms und ihr Einsatz in artifiziellen neuronalen Netzwerken (ANN). Urologe A 2007; 46:1084-6. [PMID: 17641867 DOI: 10.1007/s00120-007-1435-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- C Stephan
- Klinik für Urologie, Charité--Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin.
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