Potential Utility of Novel Biomarkers in Active Surveillance of Low-Risk Prostate Cancer

Table 1

AUCs for PSA, %fPSA, %−2proPSA, and PHI, and relationship between %−2proPSA and PHI and Gleason score.

Reference	AUC PSA	AUC %fPSA	AUC %−2proPSA	AUC PHI	Relationship of %−2proPSA and GS	Relationship of PHI and GS
	(95% CI)	(95% CI)	(95% CI)	(95% CI)
Catalona et al., 2011 [19]; ()	0.525	0.648	Not reported	0.703	Not reported	The probability of GS ≥ 7 was 26.1% when PHI < 25 and 42.1% when PHI ≥ 55
Jansen et al., 2010 [20]
Rotterdam ()	0.585 (0.535–0.634)	0.675 (0.627–0.721)	0.716 (0.669–0.759)	0.750 (0.704–0.791)	%−2proPSA discriminates GS ≥ 7 (with biopsy GS, ; with pathologic GS, )	PHI discriminates GS ≥ 7 (with biopsy GS, : <0.0001; with pathologic GS, )
Innsbruck ()	0.543 (0.473–0.594)	0.576 (0.523–0.629)	0.695 (0.644–0.743)	0.709 (0.658–0.756)	No (neither with biopsy or with pathologic GS)	No (neither with biopsy nor with pathologic GS)
Sokoll et al., 2010 [21]; ()	0.58 (0.53–0.64)	0.66 (0.61–0.71)	0.70 (0.65–0.75)	0.76 (0.72–0.81)	%−2proPSA increased with increasing GS ()	Not reported
Lazzeri et al., 2013^* [22]; ()	0.50 (0.46–0.54)	0.64 (0.61–0.68)	0.67 (0.64–0.71)	0.67 (0.64–0.71)	Significant (Spearman : 0.245; ), and it did improve the prediction of GS ≥ 7 PCa in multivariable accuracy analysis by 7.3%	Significant (Spearman : 0.276; ), and it did improve the prediction of GS ≥ 7 PCa in multivariable accuracy analysis by 7.6%
Lazzeri et al., 2013^** [23]; ()	0.55 (0.47–0.63)	0.60 (0.52–0.68)	0.73 (0.66–0.80)	0.73 (0.66–0.80)	Significant (Spearman : 0.366; ), but it did not improve the prediction of GS ≥ 7 PCa in multivariable accuracy analysis	Significant (Spearman : 0.464; ), but it did not improve the prediction of GS ≥ 7 PCa in multivariable accuracy analysis
Stephan et al., 2013 [24]; ()	0.56 (0.53–0.59)	0.61 (0.59–0.64)	0.72 (0.70–0.75)	0.74 (0.71–0.76)	Significantly higher median values of %−2proPSA were observed for patients with GS ≥ 7 (%−2proPSA = 2.68) compared with a GS < 7 (%−2proPSA = 2.34; )	Significantly higher median values of phi were observed for patients with GS ≥ 7 (PHI = 59.7) compared with a GS < 7 (PHI = 53.1; )
Ng et al., 2014 [25] ()	0.547 (0.421–0.674)	0.572 (0.437–0.708)	0.768 (0.660–0.876)	0.781 (0.675–0.887)	Not reported	Not reported

AUC: area under the curve; PCa: prostate cancer; PSA: prostate-specific antigen; %fPSA: percentage of free PSA to total PSA; %−2proPSA: percentage of −2proPSA to free PSA; PHI: Prostate Health Index; GS: Gleason score; CI: confidence interval.
^*An observational, prospective, multicenter European cohort, the PROMEtheuS project.
^**A nested case-control study from the same PROMEtheuS database.