MP49-20: Potential of a combined PSA-Zinc urinary test for the detection of prostate cancer.
Sunday, May 5, 2024 7:00 AM to 9:00 AM · 2 hr. (US/Central)
221B
Abstract
Information
Full Abstract and Figures
Author Block
Sabrina Titti De Cillis*, Orbassano (Turin), Italy, Sergio Occhipinti, Turin, Italy, Daniele Amparore, Matteo Manfredi, Orbassano (Turin), Italy, Enrico Checcucci, Candiolo (Turin), Italy, Alberto Piana, Rocca di Neto, Italy, Federico Piramide, Orbassano (Turin), Italy, Gabriele Volpi, Candiolo (Turin), Italy, Michele Sica, Paolo Verri, Stefano Granato, Alberto Quara', Edoardo Cisero, Giovanni Busacca, Michele Ortenzi, Marco Colombo, Anca Georgiana Mesterca, Cecilia Gatti, Andrea Sterrantino, Davide Garino, Nadia Ziani, Orbassano (Turin), Italy, Michele Di Dio, Cosenza, Italy, Cristian Fiori, Francesco Porpiglia, Orbassano (Turin), Italy
Introduction
The aim of this study is to find out if the combined analisys of urinary levels of PSA (uPSA) plus urinary Zinc (uZinc) could have a role in identify men with PCa among candidates for prostate biopsy.
Methods
Urine samples after prostatic massages were collected from patients with suspected prostate cancer scheduled for prostate biopsy at our Institution. Quantification of uPSA was performed by ECLIA platform and confirmed by ELISA essay, while uZinc measurement was evaluated by atomic absorption and confirmed by colorimetric in vitro assay. On the basis of these assays, a Urine Score (uScore) was assigned to each urine sample as follow: 2 (both markers positive), 1 (only one marker positive), 0 (both markers negative). Six multivariate logistic regression analysis were performed to assess diagnostic performance of uScore, SOC (serum PSA, DRE, age) and MRI alone, end of MRI+SOC, MRI + uScore and MRI + uScore + SOC. The discriminative power of the logistic models was assessed by calculating the area under the receiver operating characteristic (ROC) curves (AUC).
Results
238 patients were enrolled in the study. 145 subjects were diagnosed with PCa (called hereafter CP), whereas remaining 93 subjects were free from disease (healthy subjects, HS). Median urine PSA and Zinc after prostatic massage was lower in CP than in HS. Moreover, there was an inverse correlation between the concentration of both urinary molecules and the tumour grade group. We identified the optimal cutoff for both urinary PSA and Zinc that maximize the discrimination between CP and HS in term of sensitivity and specificity. Multivariate ROC curve analysis combining uScore with SOC and MRI resulted in an AUC=0.882, that is statistically different from SOC or MRI alone, or SOC+MRI (p=0.0001, p=0.0001, and p=0.008 respectively) (figure 1). Prostate Cancer risk algorithm designed considering uScore, SOC and MRI results in potential reduction of 57% of unnecessary biopsies.
Conclusions
The loss of PSA and Zinc production and secretion by the prostate during neoplastic transformation could potentially represent a hallmark of PCa, and its combination with standard diagnostic parameters and mpMRI could represent an interesting approach in the diagnosis of PCa.
Source Of Funding
None
Author Block
Sabrina Titti De Cillis*, Orbassano (Turin), Italy, Sergio Occhipinti, Turin, Italy, Daniele Amparore, Matteo Manfredi, Orbassano (Turin), Italy, Enrico Checcucci, Candiolo (Turin), Italy, Alberto Piana, Rocca di Neto, Italy, Federico Piramide, Orbassano (Turin), Italy, Gabriele Volpi, Candiolo (Turin), Italy, Michele Sica, Paolo Verri, Stefano Granato, Alberto Quara', Edoardo Cisero, Giovanni Busacca, Michele Ortenzi, Marco Colombo, Anca Georgiana Mesterca, Cecilia Gatti, Andrea Sterrantino, Davide Garino, Nadia Ziani, Orbassano (Turin), Italy, Michele Di Dio, Cosenza, Italy, Cristian Fiori, Francesco Porpiglia, Orbassano (Turin), Italy
Introduction
The aim of this study is to find out if the combined analisys of urinary levels of PSA (uPSA) plus urinary Zinc (uZinc) could have a role in identify men with PCa among candidates for prostate biopsy.
Methods
Urine samples after prostatic massages were collected from patients with suspected prostate cancer scheduled for prostate biopsy at our Institution. Quantification of uPSA was performed by ECLIA platform and confirmed by ELISA essay, while uZinc measurement was evaluated by atomic absorption and confirmed by colorimetric in vitro assay. On the basis of these assays, a Urine Score (uScore) was assigned to each urine sample as follow: 2 (both markers positive), 1 (only one marker positive), 0 (both markers negative). Six multivariate logistic regression analysis were performed to assess diagnostic performance of uScore, SOC (serum PSA, DRE, age) and MRI alone, end of MRI+SOC, MRI + uScore and MRI + uScore + SOC. The discriminative power of the logistic models was assessed by calculating the area under the receiver operating characteristic (ROC) curves (AUC).
Results
238 patients were enrolled in the study. 145 subjects were diagnosed with PCa (called hereafter CP), whereas remaining 93 subjects were free from disease (healthy subjects, HS). Median urine PSA and Zinc after prostatic massage was lower in CP than in HS. Moreover, there was an inverse correlation between the concentration of both urinary molecules and the tumour grade group. We identified the optimal cutoff for both urinary PSA and Zinc that maximize the discrimination between CP and HS in term of sensitivity and specificity. Multivariate ROC curve analysis combining uScore with SOC and MRI resulted in an AUC=0.882, that is statistically different from SOC or MRI alone, or SOC+MRI (p=0.0001, p=0.0001, and p=0.008 respectively) (figure 1). Prostate Cancer risk algorithm designed considering uScore, SOC and MRI results in potential reduction of 57% of unnecessary biopsies.
Conclusions
The loss of PSA and Zinc production and secretion by the prostate during neoplastic transformation could potentially represent a hallmark of PCa, and its combination with standard diagnostic parameters and mpMRI could represent an interesting approach in the diagnosis of PCa.
Source Of Funding
None