| Abstract [eng] |
Prostate cancer is the second most common cancer in males worldwide and the most frequently occurring cancer among males in Lithuania. Prostate-specific antigen (PSA) in blood serum still remains the most commonly performed diagnostic prostate cancer test. While PSA is an organ-specific, not cancer-specific biomarker. It demonstrates low specificity in determing prostate cancer in males with PSA level below 10 ng/mL. The aim of this dissertation is to evaluate the diagnostic potential of molecular serum biomarker [-2]proPSA and its derivatives %p2PSA, prostate health index (PHI) and prostate health index density (PHID) for early prostate cancer diagnosis in males with serum PSA levels of 2 – 10 ng/mL and negative digital rectal examination. Prostate cancer has been diagnosed in 112 (53.3%) out of 210 males enrolled in the study. Clinically significant prostate cancer according to Epstein’s criteria and 2014 ISUP classification has been identified in 72.3% and 35.7% out of 112 patients at biopsy, respectively. Overall, 51 patients underwent radical prostatectomy. Clinically significant prostate cancer at the final pathology was diagnosed in 74.5% of patients. PHI and PHID have demonstrated the best combination of sensitivity, specificity, positive and negative predictive value, as well as diagnostic accuracy in predicting overall and clinically significant prostate cancer. PHI significantly improved the diagnostic accuracy of multivariate model consisted of demographic, clinical and other blood serum biomarkers in predicting ISUP grade ≥ 2 prostate cancer. |
