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Prostate Cancer Diagnosis Using Urine Sediment Analysis-Based α-Methylacyl-CoA Racemase Score: A Single-Center Experience
To evaluate the diagnostic value of α-methylacyl-CoA racemase (AMACR) score in Han Chinese patients with prostate cancer (PCa) through urine sediment analysis. We collected 292 urine sediment samples after digital rectal examination. Levels of AMACR and prostate-specific antigen (PSA) messenger RNA...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6891009/ https://www.ncbi.nlm.nih.gov/pubmed/31793344 http://dx.doi.org/10.1177/1073274819887697 |
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author | Ji, Jin Chen, Xi Xu, Yalong Cao, Zhi Xu, Huan kong, Chen Wang, Fubo Sun, Yinghao |
author_facet | Ji, Jin Chen, Xi Xu, Yalong Cao, Zhi Xu, Huan kong, Chen Wang, Fubo Sun, Yinghao |
author_sort | Ji, Jin |
collection | PubMed |
description | To evaluate the diagnostic value of α-methylacyl-CoA racemase (AMACR) score in Han Chinese patients with prostate cancer (PCa) through urine sediment analysis. We collected 292 urine sediment samples after digital rectal examination. Levels of AMACR and prostate-specific antigen (PSA) messenger RNA (mRNAs) were evaluated by quantitative real time-polymerase chain reaction. The diagnostic value of AMACR score was assessed by receiver-operating characteristic analysis (ROC), Mann-Whitney test, logistic regression analysis and decision curve analysis. In all patients (n = 292), the area under the curve (AUC) for serum PSA, AMACR score, and a combinative model of these 2 parameters were 0.745 (95% confidence interval [CI]: 0.691-0.794), 0.753 (95% CI: 0.700-0.802), and 0.784 (95% CI: 0.732-0.830). No statistical difference was found between AMACR score and serum PSA (P = .826), while the combinative model was better than AMACR score (Z = 5.222, P < .001). Among patients with serum PSA level of 4 to 10 ng/mL (n = 121), the AMACR score was significantly higher in patients with PCa (P = 0.0002), while serum PSA showed no difference (P = 0.3023). Alpha-methylacyl-CoA racemase score (AUC = 0.712, 95% CI: 0.623-0.790) and a combinative model (AUC = 0.714, 95% CI: 0.626-0.793) showed a better diagnostic value than serum PSA (AUC = 0.559, 95% CI: 0.466-0.649), (P = .048, P = .042). Decision curve analysis showed a biopsy prediction model including AMACR score have a better net benefit when the threshold probability greater than 20%. The diagnostic model combing serum PSA and AMACR score has a better diagnostic value in patients with abnormal PSA level (including PSA level ranging from 4-10 ng/mL), and could reduce unnecessary prostate biopsy in clinical use. |
format | Online Article Text |
id | pubmed-6891009 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-68910092019-12-12 Prostate Cancer Diagnosis Using Urine Sediment Analysis-Based α-Methylacyl-CoA Racemase Score: A Single-Center Experience Ji, Jin Chen, Xi Xu, Yalong Cao, Zhi Xu, Huan kong, Chen Wang, Fubo Sun, Yinghao Cancer Control Research Article To evaluate the diagnostic value of α-methylacyl-CoA racemase (AMACR) score in Han Chinese patients with prostate cancer (PCa) through urine sediment analysis. We collected 292 urine sediment samples after digital rectal examination. Levels of AMACR and prostate-specific antigen (PSA) messenger RNA (mRNAs) were evaluated by quantitative real time-polymerase chain reaction. The diagnostic value of AMACR score was assessed by receiver-operating characteristic analysis (ROC), Mann-Whitney test, logistic regression analysis and decision curve analysis. In all patients (n = 292), the area under the curve (AUC) for serum PSA, AMACR score, and a combinative model of these 2 parameters were 0.745 (95% confidence interval [CI]: 0.691-0.794), 0.753 (95% CI: 0.700-0.802), and 0.784 (95% CI: 0.732-0.830). No statistical difference was found between AMACR score and serum PSA (P = .826), while the combinative model was better than AMACR score (Z = 5.222, P < .001). Among patients with serum PSA level of 4 to 10 ng/mL (n = 121), the AMACR score was significantly higher in patients with PCa (P = 0.0002), while serum PSA showed no difference (P = 0.3023). Alpha-methylacyl-CoA racemase score (AUC = 0.712, 95% CI: 0.623-0.790) and a combinative model (AUC = 0.714, 95% CI: 0.626-0.793) showed a better diagnostic value than serum PSA (AUC = 0.559, 95% CI: 0.466-0.649), (P = .048, P = .042). Decision curve analysis showed a biopsy prediction model including AMACR score have a better net benefit when the threshold probability greater than 20%. The diagnostic model combing serum PSA and AMACR score has a better diagnostic value in patients with abnormal PSA level (including PSA level ranging from 4-10 ng/mL), and could reduce unnecessary prostate biopsy in clinical use. SAGE Publications 2019-12-03 /pmc/articles/PMC6891009/ /pubmed/31793344 http://dx.doi.org/10.1177/1073274819887697 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Research Article Ji, Jin Chen, Xi Xu, Yalong Cao, Zhi Xu, Huan kong, Chen Wang, Fubo Sun, Yinghao Prostate Cancer Diagnosis Using Urine Sediment Analysis-Based α-Methylacyl-CoA Racemase Score: A Single-Center Experience |
title | Prostate Cancer Diagnosis Using Urine Sediment Analysis-Based
α-Methylacyl-CoA Racemase Score: A Single-Center Experience |
title_full | Prostate Cancer Diagnosis Using Urine Sediment Analysis-Based
α-Methylacyl-CoA Racemase Score: A Single-Center Experience |
title_fullStr | Prostate Cancer Diagnosis Using Urine Sediment Analysis-Based
α-Methylacyl-CoA Racemase Score: A Single-Center Experience |
title_full_unstemmed | Prostate Cancer Diagnosis Using Urine Sediment Analysis-Based
α-Methylacyl-CoA Racemase Score: A Single-Center Experience |
title_short | Prostate Cancer Diagnosis Using Urine Sediment Analysis-Based
α-Methylacyl-CoA Racemase Score: A Single-Center Experience |
title_sort | prostate cancer diagnosis using urine sediment analysis-based
α-methylacyl-coa racemase score: a single-center experience |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6891009/ https://www.ncbi.nlm.nih.gov/pubmed/31793344 http://dx.doi.org/10.1177/1073274819887697 |
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