Clinical performance of serum isoform [-2]proPSA (p2PSA) and its derivatives, namely %p2PSA and PHI (Prostate Health Index) in men younger than 60 years of age. Results from a multicentric European study (PROMEtheuS project). MASSIMO LAZZERI - NICOLA FOSSATI - ALESSANDRO LARCHER - ALBERTO ABRATE - GIOVANNI LUGHEZZANI - GIORGIO GUAZZONI SCOPO DELLO STUDIO Confrontare il [-2]proPSA (p2PSA) e i suoi derivati, %p2PSA e PHI (prostate health index) con I test di riferimento (tPSA, fPSA e %fPSA) nel rilevare un Carcinoma Prostatico (Pca) in pazienti giovani (<60 anni). Index tests Reference standard tests %p2PSA PHI tPSA fPSA f/tPSA Dipartimento di Urologia, San Raffaele Turro, Università Vita-Salute San Raffaele, Milano

[-2]PROPSA AND DERIVATES p2PSA free PSA (p2PSA pg/ml) (free PSA ng/ml × 1000)] × 100) × √tPSA]

MATERIALI E METODI STIUDY DESIGN: a nested case sontrol from the PRO-psa Multicentric European Study (Prometetheus) PRIMARY OUTCOMES: to test the sensibility, specificity and accuracy of serum p2PSA, percentage of p2PSA to fPSA (%p2PSA) and Beckman Coulter PHI (Prostate Health Index) in men younger than 60 years of age who had undergone prostatic biopsy for suspected Pca. STATISTICAL ANALYSIS: multivariable logistic regression models were complemented by predictive accuracy analysis and decision curve analysis.

RISULTATI OverallAbsence of PCaPresence of PCa (71.9%)67 (28.1%)

RISULTATI Receiver operating characteristic curves depicting the accuracy of individual predictors of prostate cancer at initial extended biopsies.

Cut - Off

Avoided Biopsies

CONCLUSIONI Our findings showed that %p2PSA and PHI are more accurate than the reference standard tests (tPSA, fPSA and %fPSA) in predicting PCa in men younger than 60 years of age and may also be indicative of cancer aggressiveness. These results should be taken into account when considering PCa screening studies in young patients.

MASSIMO LAZZERI (1) - NICOLA FOSSATI (1) - ALESSANDRO LARCHER (1) - ALBERTO ABRATE (1) - GIOVANNI LUGHEZZANI (2) - GIORGIO GUAZZONI (1) Dipartimento di Urologia, San Raffaele Turro, Università Vita-Salute San Raffaele, Milano Clinical performance of serum isoform [-2]proPSA (p2PSA) and its derivatives, namely %p2PSA and PHI (Prostate Health Index) in men younger than 60 years of age. Results from a multicentric European study (PROMEtheuS project).