Combination of markers in early detection of prostate cancer

Objective: Establish the combination of totalPSA, %freePSA and [-2]proPSA biomarkers and calculation of PHI in the diagnostic algorithm of early prostate cancer. Material and Methods: We examined the serum from 76 suspected prostate cancer patients. All these patients had undergone a TRUS biopsy. We performed an assessment of total PSA and, if the interval of tPSA was between 0-30 ug/l, we also assessed the levels of freePSA and [-2] proPSA and calculated the free PSA percentage (% freePSA) and Prostate Health Index (PHI). The monitored biomarkers were measured using chemiluminescent technology on a DxI 800 (Beckman Coulter, USA). All statistical analyses were calculated using SAS version 9.2. Results: We found a statistically significant increase in levels of [-2] proPSA and PHI in patients diagnosed with prostate cancer through prostate biopsy compared to patients with benign prostate hypertrophy ([-2] proPSA median 14 vs. 27 ng/l, PHI median 35 vs. 77). In contrast, we did not find any significant difference in tPSA and % freePSA (median tPSA 7.1 vs. 7.7 ug/l and % freePSA 16 vs. 11.4%). Conclusion: The combination of [-2] proPSA and calculation of PHI with traditional prostate cancer markers appear to be of great benefit for a more accurate differential diagnosis between benign hyperplasia and prostate cancer.